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- Title
Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)
- Authors
Christopeit, Maximilian; Schmidt-Hieber, Martin; Sprute, Rosanne; Buchheidt, Dieter; Hentrich, Marcus; Karthaus, Meinolf; Penack, Olaf; Ruhnke, Markus; Weissinger, Florian; Cornely, Oliver A.; Maschmeyer, Georg
- Abstract
To ensure the safety of high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT), evidence-based recommendations on infectious complications after HDC/ASCT are given. This guideline not only focuses on patients with haematological malignancies but also addresses the specifics of HDC/ASCT patients with solid tumours or autoimmune disorders. In addition to HBV and HCV, HEV screening is nowadays mandatory prior to ASCT. For patients with HBs antigen and/or anti-HBc antibody positivity, HBV nucleic acid testing is strongly recommended for 6 months after HDC/ASCT or for the duration of a respective maintenance therapy. Prevention of VZV reactivation by vaccination is strongly recommended. Cotrimoxazole for the prevention of Pneumocystis jirovecii is supported. Invasive fungal diseases are less frequent after HDC/ASCT, therefore, primary systemic antifungal prophylaxis is not recommended. Data do not support a benefit of protective room ventilation e.g. HEPA filtration. Thus, AGIHO only supports this technique with marginal strength. Fluoroquinolone prophylaxis is recommended to prevent bacterial infections, although a survival advantage has not been demonstrated.
- Subjects
STEM cell transplantation; DIAGNOSIS; MEDICAL societies; COMMUNICABLE diseases; ANTIBIOTIC prophylaxis; MYCOSES; PNEUMOCYSTIS jiroveci
- Publication
Annals of Hematology, 2021, Vol 100, Issue 2, p321
- ISSN
0939-5555
- Publication type
Article
- DOI
10.1007/s00277-020-04297-8