Infections after hematopoietic stem cell transplantation - Revision history

Aidan: added more autoHSCT info

2023-07-28T16:42:00Z

added more autoHSCT info

← Older revision		Revision as of 16:42, 28 July 2023
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	\|}		\|}

	===Antimicrobial Prophylaxis===		===Antimicrobial Prophylaxis in AlloHSCT===
	{\| class="wikitable"		{\| class="wikitable"
	! rowspan="2" \|Time		! rowspan="2" \|Time
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	\|-		\|-
	\|'''Pre-engraftment'''<br />day 0 to 30		\|'''Pre-engraftment'''<br />day 0 to 30
	\|[[levofloxacin]] or other [[fluoroquinolone]]		\|[[levofloxacin]] or other [[fluoroquinolone]] starting D+1 until engraftment (ANC>1 x3d)
	\|[[HSV]]-positive: ([[valacyclovir\|val]])[[acyclovir]]		\|[[HSV]]-positive: ([[valacyclovir\|val]])[[acyclovir]]
	[[VZV]]-positive: ([[valacyclovir\|val]])[[acyclovir]]		[[VZV]]-positive: ([[valacyclovir\|val]])[[acyclovir]]
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	\|[[VZV]]-positive: ([[valacyclovir\|val]])[[acyclovir]]		\|[[VZV]]-positive: ([[valacyclovir\|val]])[[acyclovir]]
	[[CMV]]-positive: [[valganciclovir]] or preemptive therapy		[[CMV]]-positive: [[valganciclovir]] or preemptive therapy
	\|[[fluconazole]] (or [[voriconazole]] or [[posaconazole]]) (to day 75)		\|[[fluconazole]] (or [[voriconazole]] or [[posaconazole]]) (to day 75-100 and off immunosuppression)
	[[TMP-SMX]] for [[PJP]]		[[TMP-SMX]] for [[PJP]]
	\|-		\|-
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	=== Autologous HSCT ===		=== Autologous HSCT ===

			* Bacterial
	* Can consider [[levofloxacin]] prophylaxis, which decreases risk of infection but doesn't affect mortality
	* Can consider [[~~TMP-SMX~~]] prophylaxis ~~for~~ ~~[[PJP]] for at least 3 months~~ ~~and~~ ~~until~~ ~~CD4~~ ~~count~~ is ~~about~~ ~~200~~		** Can consider [[levofloxacin]] prophylaxis, which decreases risk of infection but doesn't affect mortality
			* Viral
	* Suggest [[acyclovir]] as [[HSV]]/[[VZV]] prophylaxis for at least 6 months
	* No ~~role~~ ~~for antifungal or~~ [[~~CMV~~]] prophylaxis		** Suggest [[acyclovir]] as [[HSV]]/[[VZV]] prophylaxis for at least 6 months
	* ~~Monitor~~ for [[~~EBV~~]] ~~reactivation, which is a concern~~		** No role for [[CMV]] prophylaxis
			** Monitor for [[EBV]] reactivation, which is a concern
	* [[Tenofovir]] or [[entecavir]] as [[HBV]] prophylaxis in patients with positive HBsAg or HBcAb, with serial monitoring of HBV DNA		** [[Tenofovir]] or [[entecavir]] as [[HBV]] prophylaxis in patients with positive HBsAg or HBcAb, with serial monitoring of HBV DNA
			* Fungal
			** Can consider [[TMP-SMX]] prophylaxis for [[PJP]] for at least 3-6 months and until CD4 count is about 200
			** No role for antifungal, but can consider until ANC over 1 for 3 days

	==Further Reading==		==Further Reading==

Aidan at 16:35, 28 July 2023

2023-07-28T16:35:25Z

@@ Line 42: / Line 42: @@
 ==Prevention==
 {| class="wikitable"
 !Infection
@@ Line 187: / Line 193: @@
 |[[posaconazole]], [[TMP-SMX]] for [[PJP]]
 |}
 ==Further Reading==

Aidan: Text replacement - " species]]" to "]]"

2022-01-27T19:17:24Z

Text replacement - " species]]" to "]]"

← Older revision		Revision as of 19:17, 27 January 2022
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	\|Seropositivity is not a contraindication to receiving transplant.		\|Seropositivity is not a contraindication to receiving transplant.
	\|-		\|-
	\|[[Plasmodium ~~species~~]]		\|[[Plasmodium]]
	\|Exclusion of donors who have traveled to malaria-endemic area in past 1 year, or who have lived in an endemic area in past 3 years. If not feasible to wait, consider treating donor empirically before donation.		\|Exclusion of donors who have traveled to malaria-endemic area in past 1 year, or who have lived in an endemic area in past 3 years. If not feasible to wait, consider treating donor empirically before donation.
	\|Pre-transplant screening of recipients by blood smear, rapid test, or PCR.		\|Pre-transplant screening of recipients by blood smear, rapid test, or PCR.

Aidan: Text replacement - "Bordatella" to "Bordetella"

2022-01-25T16:59:42Z

Text replacement - "Bordatella" to "Bordetella"

← Older revision		Revision as of 16:59, 25 January 2022
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	\|Immunization of all HCT recipients. Post-exposure prophylaxis if exposed.		\|Immunization of all HCT recipients. Post-exposure prophylaxis if exposed.
	\|-		\|-
	\|''[[~~Bordatella~~ pertussis]]''		\|''[[Bordetella pertussis]]''
	\|Ensuring up-to-date immunizations of close contacts.		\|Ensuring up-to-date immunizations of close contacts.
	\|Immunization of all HCT recipients. Post-exposure prophylaxis if exposed.		\|Immunization of all HCT recipients. Post-exposure prophylaxis if exposed.

Aidan: Aidan moved page Hematopoietic stem cell transplantation to Infections after hematopoietic stem cell transplantation

2020-10-22T14:51:24Z

Aidan moved page Hematopoietic stem cell transplantation to Infections after hematopoietic stem cell transplantation

← Older revision	Revision as of 14:51, 22 October 2020
(No difference)

Aidan: /* Antimicrobial Prophylaxis */

2020-08-15T20:59:21Z

Antimicrobial Prophylaxis

← Older revision		Revision as of 20:59, 15 August 2020
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	\|[[Toxoplasma gondii]]		\|[[Toxoplasma gondii]]
	\|Provide education about decreasing risk.		\|Provide education about decreasing risk.
	\|Pretransplant screening of IgG antibody (reactivation in 2 to 6% of those who are positive). Consider preemptive therapy or prophylaxis for high-risk (e.g. allogeneic HSCT) recipients. Not needed for autologous transplants.		\|Pretransplant screening of IgG antibody (reactivation in 2 to 6% of those who are positive). Consider preemptive therapy or prophylaxis for high-risk (e.g. allogeneic HSCT) recipients; note that prophylaxis with [[TMP-SMX]] may already be indicated for [[Pneumocystis]], above. Not needed for autologous transplants.
	\|-		\|-
	\|[[Strongyloides stercoralis]]		\|[[Strongyloides stercoralis]]

Aidan: /* Prevention */

2020-08-15T20:56:40Z

Prevention

@@ Line 124: / Line 124: @@
+|
 |[[TMP-SMX]] in recipients of alloHSCT from engraftment until 6 months after transplant.
 |}

Aidan: changed proph table to a timeline

2020-08-13T14:06:08Z

changed proph table to a timeline

Show changes

Aidan: Text replacement - "Varicella zoster" to "Varicella-zoster"

2020-08-04T00:41:24Z

Text replacement - "Varicella zoster" to "Varicella-zoster"

← Older revision		Revision as of 00:41, 4 August 2020
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	\| [[Acyclovir]] for all seropositive recipients of alloHSCT from conditioning until engraftment (about 30 days). Not necessary if receiving prophylaxis for CMV.		\| [[Acyclovir]] for all seropositive recipients of alloHSCT from conditioning until engraftment (about 30 days). Not necessary if receiving prophylaxis for CMV.
	\|-		\|-
	\| [[Varicella zoster virus]]		\| [[Varicella-zoster virus]]
	\| Pre-transplant screening of donor and recipient IgG serostatus. Close contacts should have up-to-date vaccinations before visiting.		\| Pre-transplant screening of donor and recipient IgG serostatus. Close contacts should have up-to-date vaccinations before visiting.
	\| [[Acyclovir]] or [[valacyclovir]] for all seropositive recipients of alloHSCT from conditioning until 1 year and during chronic GVHD. Post-exposure prophylaxis with VariZIG for seronegative recipients.		\| [[Acyclovir]] or [[valacyclovir]] for all seropositive recipients of alloHSCT from conditioning until 1 year and during chronic GVHD. Post-exposure prophylaxis with VariZIG for seronegative recipients.

Aidan at 01:54, 17 June 2020

2020-06-17T01:54:16Z

← Older revision		Revision as of 01:54, 17 June 2020
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	See also:		See also:
	* [[Conditioning regimens in HSCT]]		* [[Conditioning regimens for HSCT]]

	==Timeline of Infections==		==Timeline of Infections==