Updates in hematopoietic cell transplant and cellular therapies that enhance the risk for opportunistic infections

Abstract

BackgroundInfectious disease physicians may be asked to evaluate and manage a variety of infections in immunocompromised hosts undergoing hematopoietic cell transplant (HCT) and cellular therapies. Over the last decade, several advances in cellular therapy have occurred, with implications for the types of infectious complications that may be seen.AimsThe purpose of this review is to update the infectious disease physician on newer advances in HCT and cellular therapy, including haploidentical transplant, expanding indications for transplant in older individuals and children, and chimeric antigen receptor T‐cells. We will review how these advances might influence infectious disease complications following HCT. We will also provide a perspective that infectious disease physicians can use to evaluate the degree of immune suppression in an individual patient to help determine the type of infections that may be encountered.

Modeling Invasive Aspergillosis Risk for the Application of Prophylaxis Strategies

“…Over the last 50 years the treatment of hematological malignancies has evolved [ 7 ]. Allogeneic HCT practices have changed to include peripheral blood as a stem cell source [ 8 ] and a wider spectrum of alternative donor sources such as cord blood, haploidentical donors, and mismatched unrelated donors [ 9 ].…”

“…The spectrum of patients potentially at risk for Aspergillus is also evolving in parallel with changes in the types of treatments for various medical conditions [ 7 ]. Nonmyeloablative conditioning regimens have permitted older patients to be considered as candidates for allogeneic HCT.…”