Post-transplant infections: single center experience from the developing world.

Area of Science:

• Hematology
• Transplant Immunology
• Infectious Diseases

Background:

• Allogeneic stem cell transplantation (SCT) is a critical treatment for hematological disorders.
• Post-transplant infections pose a significant risk to SCT recipients.
• Understanding infection patterns is crucial for improving outcomes in SCT.

Purpose of the Study:

• To document the incidence and types of post-transplant infections.
• To analyze infection-related mortality in allogeneic SCT recipients.
• To evaluate the effectiveness of infection prophylaxis and management strategies.

Main Methods:

• Retrospective analysis of 154 allogeneic SCT patients (July 2001-September 2006).
• Patients received transplants from human leukocyte antigen (HLA)-matched sibling donors.
• Infection surveillance, prophylaxis, protective isolation, and GVHD prophylaxis (cyclosporin, prednisolone) were employed.

Main Results:

• 90.9% of patients developed febrile episodes; 77.9% had confirmed post-transplant infections.
• Infection-related mortality was 13.0%.
• Cytomegalovirus (CMV) disease, disseminated aspergillosis, and pseudomonas septicemia were associated with high mortality.

Conclusions:

• High incidence of febrile episodes observed, with low microbiological culture positivity.
• Cytomegalovirus, aspergillosis, and pseudomonas infections remain challenging, contributing to significant mortality.
• Effective management of these specific infections is critical for improving survival rates post-allogeneic SCT.