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Published on: February 23, 2014

Pneumococcal infections after human bone-marrow transplantation

D J Winston, G Schiffman, D C Wang

    Annals of Internal Medicine
    |December 1, 1979
    PubMed

    Insights

    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.

    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.

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