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Abstract HCT patients are at risk for severe bacterial infection, the most frequent of them are bloodstream infections (BSI). The majority occur at the pre-engraftment period. Primary BSIs are mainly central line catheter-related (CRBSI) or mucosal barrier injury-associated. Secondary BSI accompanies site-specific infection (e.g., Pseudomonas aeruginosa pneumonia and BSI). GNB has become an increasingly common cause of BSI, and are...
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Abstract Patients undergoing HCT receive polymedication which carries the potential to result in drug interactions. To avoid unexpected outcomes, attention to drug interactions is crucial, especially when drugs with a narrow therapeutic index or inherent toxicity profile are involved.
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Abstract Haemorrhagic cystitis is a frequent complication after haematopoietic cell transplantation. Supportive measures (analgesics, antispasmodics, blood product transfusions and hyperhydration) are the main mode of treatment, with or without antivirals or experimental approaches (hyperbaric oxygen therapy, fibrin-glue or platelet-rich plasma application, adoptive immunotherapy).
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Abstract Vaccination should be considered a routine practice for all HCT receptors , either autologous or allogeneic, adults or children. It should be implemented in all HCT programs. Adult cover is particularly important as they represent 90% of HCTs.
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Abstract Acute graft-versus-host disease (GvHD) remains a major course of short term (100 days and 1 yr) mortality and morbidity after allogeneic stem cell transplantation. The pathophysiology of GvHD is described as a 3 step process starting with initial tissue damage by conditioning followed by host antigen presenting cell activation by damage and pathogen associated molecular patterns and finally resulting in activation of alloreactive T cells and proinflmmatory cytokines...
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Abstract Viral infections are important and possibly serious complications to cellular therapies especially allogeneic hematopoietic stem cell transplantation. The most important virus infections are caused by the herpesviruses, adenovirus, and community acquired respiratory viruses including SARS-CoV-2, but also other more rare infections require attention. This chapter discusses some of these infections and their management
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Abstract Invasive fungal diseases are potentially life-threatening infectious complications following HCT and CAR-T cell treatment. The successful introduction of azole-based antifungal prophylaxis has dramatically changed the fungal epidemiology and resistance patterns in many institutions. Timely and accurate diagnosis remains a challenge, especially for mould infections, and relies nowadays heavily on the detection of fungal biomarkers, fungal DNA, and sensitive imaging....
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Abstract Toxoplasma gondii is a protozoan that commonly infects animals and birds. Primary T. gondii infection in humans and other mammals is usually asymptomatic but leads to lifelong latent infection. Transmission to humans occurs by ingesting tissue cysts from undercooked meat or oocysts (released in the feces of cats). Latent cysts can give rise during immunosuppression to a severe localized reactivation producing, for...
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Abstract Infection control is defined as a set of measures aimed at preventing or stopping the spread of infections in healthcare settings. Isolation procedures are a set of standard recommendations designed to reduce the risk of transmission of different infectious agents from body fluids or environmental surfaces.
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Abstract Fever during neutropenia is almost universal after an HCT. In neutropenic HCT recipients, clinicians are faced with a unique combination of issues: (1) high incidence of bacterial bloodstream infections, (2) high mortality in case of infections due to Gram-negative bacteria unless effective antibiotic treatment is provided promptly, and (3) numerous causes of fever other than bacterial infection.
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Abstract Chronic GVHD (cGVHD) is the most relevant cause of late non-relapse morbidity and subsequent mortality (approximately 25%) following allo-HCT (Grube et al. 2016). Its incidence is approximately 50% among all patients following allo-HCT and has increased during the last two decades due to increasing patient age and increasing use of unrelated and/or mismatched donors, RIC regimens, PBSC with application of standard GVHD prophylaxis (calcineurin inhibitor [CNI] + MMF or...
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CORE CURRICULUM
- SYNDROMES (1)
HEME-ONC AND CELLULAR THERAPIES
- GVHD (2)
- Neutropenia (1)