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A review of infectious complications after haploidentical hematopoietic stem cell transplantations

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Abstract

Background

Allogeneic hematopoietic stem cell transplantation from haploidentical donor is a feasible option for patients with hematological diseases who lack a suitable HLA-matched donor, but viral and fungal infections are still the most common causes of morbidity and mortality in haploidentical transplantation setting because of delayed immune reconstitution, increased risk of graft vs host disease (GvHD) or systemic steroid use. Therefore, this review will focus on the infectious complications after haploidentical hematopoietic stem cell transplantation (HSCT).

Materials and methods

Electronic publications were searched until February 2017 throughout databases, including Pubmed, Cochrane, and Embase. The following keywords were used ‘haploidentical transplantation’, ‘infection’, ‘T cell replete’, and ‘T cell deplete’.

Results

An increased incidence of bacterial, fungal, or viral infections is detected in haplo-HSCT compared to related, unrelated, or cord blood transplantations. Neutropenia and use of systemic steroid for GvHD and delayed immune reconstitution are important risk factors for infection after haplo-HSCT.

Conclusion

A shift towards T cell repletes haplo-HSCT with post-transplant cyclophosphamide (CY) for GvHD has been emerged in recent years, in which the incidence of viral and fungal infections is detected to be lower. Prophylaxis and pre-emptive treatment strategies should be applied according to patient status.

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Authors and Affiliations

  1. Department of Hematology, Ankara University Medical School, Cebeci, 06590, Ankara, Turkey

    Erden Atilla, Pinar Ataca Atilla, Sinem Civriz Bozdağ & Taner Demirer

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  1. Erden Atilla
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  2. Pinar Ataca Atilla
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  4. Taner Demirer
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All authors contributed equally to this review.

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Correspondence to Taner Demirer.

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Atilla, E., Atilla, P.A., Bozdağ, S.C. et al. A review of infectious complications after haploidentical hematopoietic stem cell transplantations. Infection 45, 403–411 (2017). https://doi.org/10.1007/s15010-017-1016-1

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