Infectious complications and vaccines

Abstract

Infections are a major cause of morbidity and can result in mortality in long-term survivors after allogeneic hematopoietic cell transplantation. Chronic graft-versus-host disease and delayed immune reconstitution are recognized risk factors. Different strategies must be utilized depending on the individual patient's situation but include prolonged antimicrobial prophylaxis and vaccination. Some important infections due to pathogens preventable by vaccination are pneumococci, influenza, varicella-zoster virus, and SARS-CoV-2. Despite the fact that such recommendations have been in place for decades, implementation of these recommendations has been reported to be poor.

Prevention and treatment of COVID-19 in patients with benign and malignant blood disorders

“…A vaccine series given before recovery of the immune system may not induce a protective immune response, while delaying vaccination might place the patient at risk of infection. The long-acting monoclonal antibodies combination tixagevimab-cilgavimab, discussed below, might be administered to decrease the interim risk of infection [ 46 ]. Although they can get infected with COVID in the hospital, patients with recent HSCT and CAR-T cell therapy are more likely to acquire infection from exposure to caregivers, and it is recommended that all close contacts of HSCT and CAR-T therapy patients receive COVID-19 vaccine as per CDC schedule.…”

Chimeric Antigen Receptor T-cell Therapy for Chronic Lymphocytic Leukemia: What is the supporting evidence so far?

“…15 While reduced intensity conditioning (RIC) regimens improved tolerability of allo-HCT in this population of patients with generally advanced age and existing comorbidities, applicability of the procedure remains limited, due to toxicities, mainly acute and chronic graft-versus-host disease (GVHD), organ failure, infections, and resulting non-relapse mortality. 16,17 Chimeric antigen receptor T-cell (CAR T) therapy epitomizes the successful advances in cancer immunology and T-cell engineering. These therapies have modernized the treatment algorithms of various types of B-cell non-Hodgkin lymphomas (NHL) and B-cell acute lymphoblastic leukemia (ALL).…”