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Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
[Rare viral infections during immunosuppressive therapy: a "normal" side effect?]
1Innere Abteilung, Kreisklinik Trostberg, Kliniken Südostbayern, Trostberg, Deutschland. thomas.glueck@kreisklinik-trostberg.de
Biological therapies for rheumatic diseases increase infection risk, particularly progressive multifocal leukoencephalopathy (PML) from JC polyoma virus reactivation. Caution is advised, especially with combined immunosuppression and in elderly patients.
Area of Science:
- Rheumatology
- Immunology
- Infectious Diseases
Context:
- Biological therapies offer enhanced treatment for active rheumatic diseases.
- These advanced treatments can lead to significant immunosuppression.
Purpose:
- To highlight the increased risk of opportunistic infections associated with biologicals.
- To specifically address the heightened risk of progressive multifocal leukoencephalopathy (PML) due to JC polyoma virus reactivation.
Summary:
- Biologicals, while effective for rheumatic diseases, increase the risk of opportunistic infections.
- Certain biologicals (natalizumab, efalizumab, rituximab) carry a specific risk for JC polyoma virus reactivation, leading to fatal PML.
- Combined immunosuppressive therapy, corticosteroids, and advanced age are risk factors for these severe infections.
Impact:
- Emphasizes the need for cautious use of biologicals in immunosuppressed patients.
- Recommends careful patient selection and monitoring to mitigate risks.
- Informs clinicians about the severe, potentially fatal side effects of specific biological agents.
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