Infectious Complications in Bone Marrow Transplantation

1. Front Matter

   Pages I-XV

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2. Introduction

   1. Bone Marrow Transplantation for Cancer: An Overview

      • D. D. Hurd

      Pages 1-14

   2. Infection in Bone Marrow Transplantation: A Model for Examining Predisposing Factors to Infection in Cancer Patients

      • S. C. Schimpff

      Pages 15-34

3. Case Presentation

   1. Introduction to Case Presentation

      • S. C. Schimpff

      Pages 35-44

4. Infection and Granulocytopenia

   1. Initial Empiric Therapy for Fever in Neutropenia

      • C. I. Bustamante

      Pages 45-56

   2. Approach to the Patient with Prolonged Granulocytopenia

      • P. A. Pizzo

      Pages 57-65

   3. Simplification of Empiric Therapy for the Febrile, Neutropenic Oncology Patient

      • J. L. Shenep

      Pages 67-77

   4. Fever and Granulocytopenia: A Viewpoint from an Academic Setting

      • N. J. Vogelzang, J. P. Flaherty

      Pages 79-88

   5. Empiric Antimicrobial Therapy in the Community Hospital Setting for the Cancer Patient with Fever and Neutropenia: The Need for Vigilance and Attention to Detail

      • J. G. Gallagher

      Pages 89-96

   6. Observations on the Effects of Hematopoietic Colony-Stimulating Factors on the Clinical Course of Bone Marrow Transplantation

      • W. P. Peters

      Pages 97-101

   7. Effect of Colony-Stimulating Factors on Granulocyte Function

      • K. Vollmer, G. L. Mandell

      Pages 103-108

   8. Invasive Aspergillosis: Host Defenses

      • R. D. Diamond

      Pages 109-115

   9. Invasive Aspergillosis: Serologic Diagnosis

      • V. T. Andriole

      Pages 117-125

   10. Aspergillosis in the Immunocompromised: Focus on Treatment

       • M. Aoun, P. Van der Auwera, J. Gèrain, J. Klastersky

       Pages 127-136

   11. Invasive Candidiasis During Granulocytopenia

       • E. Anaissie, H. Pinczowski

       Pages 137-145

5. Infections and Cellular Immune Dysfunction

   1. Infections in Cancer Patients with Suppressed Cellular Immunity

      • J. Klastersky

      Pages 147-154

   2. Herpes Simplex Infections

      • R. Saral

      Pages 155-160

   3. Treatment and Prophylaxis of Cytomegalovirus Infection After Bone Marrow Transplantation

      • G. M. Schmidt

      Pages 161-174

   4. Varicella Zoster Infections in Bone Marrow Transplants

      • S. Feldman

      Pages 175-184

   5. Graft-Versus-Host Disease: Basic Considerations

      • A. J. Barrett

      Pages 185-195

As the demographics of the population shift toward an increasingly aged society, the number of individuals with cancer increases and with it the need to give the most comprehensive possible health care delivery. Although much has been written about the specific therapy best suited for the various types of cancer and about the basic and clinical research which has dramatically improved treat­ ment, overall patient care requires attention to supportive care, which includes such items as pain management, the use of blood products, nutrition, and psychosocial needs. Yet infection remains the leading cause of death in cancer patients and is a major cause of morbidity and hospitaliza­ tion, making it a major aspect of the supportive care of cancer patients. It therefore deserves a full exposition. Bone marrow transplantation is increasingly being utilized as part of a therapeutic modality in the treatment of cancer patients. Transplantation patients are at such a particularly high risk of developing a wide variety of different types of infection, that they inevitably can serve as an excellent framework for discussion of all the types of infections that occur during the treatment of cancer. The patient undergoing allogeneic bone marrow transplantation is at particularly high risk of infection due to the major perturbations of host defenses, which include granulo­ cytopenia, cellular immune dysfunction, humoral immune dysfunction, blood product transfusions, and vascular access devices. Each of these perturbations results in a different set of infectious disease problems.

• Bone marrow transplantation
• bone marrow
• cancer
• chemotherapy
• clinical trial
• infection
• oncology
• prevention
• transplantation

• University of Maryland Medical System, Baltimore, USA

  Stephen C. Schimpff

• Institut Jules Bordet, Centre des Tumeurs de l’Université Libre de Bruxelles, Brussels, Belgium

  Jean Klastersky

Policies and ethics