TY - JOUR
T1 - Infectious complications of acute and chronic GVHD
AU - Young, Jo Anne H.
PY - 2008/6
Y1 - 2008/6
N2 - Immune defects prolonged by treatment regimens for graft-versus-host disease (GVHD) include cell-mediated immunity and hypogammaglobulinemia. Infections have become increasingly important during GVHD therapy, paradoxically because the success of immunosuppressive practice has led to improved survival. Infections originate from both endogenous and exogenous sources. Regimens for prevention of infection include: (a) continued surveillance monitoring for infections with reliable diagnostic testing, and (b) antimicrobial prophylaxis for those pathogens without markers that could be followed for surveillance. Repeated episodes of the same infection, diagnosis of a new life-threatening infection, or specific underlying hematologic diagnoses should prompt a look for gross immunoglobulin deficiency that could be corrected in the short term by immunoglobulin therapy. At times, measurement of CD4+ lymphocyte counts will assist in determining whether augmented prophylaxis is warranted. Since their efficacy may be limited, vaccine injections are not given during the immunosuppression associated with GVHD therapy, with the exception of influenza.
AB - Immune defects prolonged by treatment regimens for graft-versus-host disease (GVHD) include cell-mediated immunity and hypogammaglobulinemia. Infections have become increasingly important during GVHD therapy, paradoxically because the success of immunosuppressive practice has led to improved survival. Infections originate from both endogenous and exogenous sources. Regimens for prevention of infection include: (a) continued surveillance monitoring for infections with reliable diagnostic testing, and (b) antimicrobial prophylaxis for those pathogens without markers that could be followed for surveillance. Repeated episodes of the same infection, diagnosis of a new life-threatening infection, or specific underlying hematologic diagnoses should prompt a look for gross immunoglobulin deficiency that could be corrected in the short term by immunoglobulin therapy. At times, measurement of CD4+ lymphocyte counts will assist in determining whether augmented prophylaxis is warranted. Since their efficacy may be limited, vaccine injections are not given during the immunosuppression associated with GVHD therapy, with the exception of influenza.
KW - aspergillosis
KW - cytomegalovirus
KW - hypogammaglobulinemia
KW - opportunistic infection
UR - http://www.scopus.com/inward/record.url?scp=44049083634&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=44049083634&partnerID=8YFLogxK
U2 - 10.1016/j.beha.2008.02.017
DO - 10.1016/j.beha.2008.02.017
M3 - Review article
C2 - 18503997
AN - SCOPUS:44049083634
SN - 1521-6926
VL - 21
SP - 343
EP - 356
JO - Best Practice and Research: Clinical Haematology
JF - Best Practice and Research: Clinical Haematology
IS - 2
ER -