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Pneumococcal infections after human bone-marrow transplantation.

D J Winston, G Schiffman, D C Wang

Annals of Internal Medicine

|December 1, 1979

Summary

Long-term bone-marrow transplant survivors can develop pneumococcal infections. Low antibody or complement levels increase risk, suggesting prophylactic penicillin or vaccination for transplant recipients.

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Area of Science:

Immunology
Infectious Diseases
Hematology

Background:

Bone-marrow transplantation (BMT) is a life-saving procedure.
Long-term survivors may still face infectious complications.
Pneumococcal infections pose a significant risk post-BMT.

Purpose of the Study:

To investigate the incidence and risk factors of pneumococcal infections in long-term BMT survivors.
To identify specific immunological deficits associated with these infections.
To inform recommendations for preventing pneumococcal infections in this population.

Main Methods:

Retrospective analysis of 26 long-term BMT survivors (>7 months post-transplant).
Clinical data review for infections, particularly pneumococcal.
Laboratory assessment of serum immunoglobulin (IGG, IgM) levels, complement activity (CH100), and opsonic activity against Streptococcus pneumoniae type 6A.

Main Results:

Seven of 26 survivors developed penicillin-sensitive pneumococcal infections.
Infections were associated with male gender and abnormal IGG/IGM levels.
Impaired serum opsonic activity for S. pneumoniae type 6A was observed in six patients, linked to low antibody or complement levels.

Conclusions:

Long-term BMT recipients are susceptible to pneumococcal infections.
Immunological factors, including antibody and complement deficiencies, contribute to this susceptibility.
Prophylactic penicillin or pneumococcal vaccination should be considered for BMT survivors.