How to manage infections after hematopoietic stem cell transplantation and the issue of resistance

Jan Styczynski, MD, PhD of Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland and Chair of the EBMT Infectious Diseases Working Party, discusses his talk on how to manage infections after hematopoietic stem cell transplantation (HSCT) at the 2016 EBMT International Transplant Course (EBMT-ITC) in Barcelona, Spain. According to Dr Styczynski, infections present a serious risk to HSCT patients and contribute to up to 20% of deaths following HSCT. Fungal infections and cytomegalovirus (CMV) infection in particular, are associated with high risk of mortality. He further discusses the role of prophylaxis, empiric therapy, pre-emptive therapy and targeted therapy. In case of infection, two or three of these strategies may be used. Dr Styczynski highlights that significant progress in diagnostic processes has been made and that new drugs, which are more effective and safer, are in the pipeline. He also talks about cellular therapy with the use of cytotoxic T lymphocytes. However, cellular therapy is not available everywhere and also, the emerging resistance to pathogens is a major concern. Therefore, better markers are needed to detect infection early and more drugs to fight them.

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