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Many patients without GVHD and off all IST after allogeneic HCT respond to vaccines and pathogens but a large registry study found infection to be a primary or contributing factor for almost 30% of late deaths [32]. At 12‐years post‐HCT, the CI of late fatal infections (LFI) was 6.4% in adults and 1.8% in children. Older adults and those with cGVHD on IST at 2‐years post‐HCT had highest risk for LFI. However, in children, cGVHD at 2 years carried a 9.5‐fold risk if on IST at 2 years but also a 2.7‐fold risk even if off IST [32] These data emphasize the importance of LTFU infection‐directed supportive care. Patients with active cGVHD are considered functionally asplenic. Numeric and functional immunity is delayed in patients when cGVHD is present or when HCT results in mixed T‐ and B‐cell lineage chimerism, especially if the underlying diagnosis was a primary immunodeficiency disease (PID). In general, antimicrobial prophylaxis directed against shingles, pneumocystis jirovecii pneumonia, encapsulated organisms, and often molds, is administered during cGVHD therapy [36]. In patients without cGVHD (often those with PID), if CD4 counts remain <200 per microliter or PHA proliferation is <50% lower limit of normal, PJP prophylaxis continues. Routine posttransplant vaccinations per “national guidelines” [37] or Carpenter and Englund is advised [38]. Judicious use of immunoglobulin replacement therapy for allogeneic HCT recipients per ASTCT “Choosing Wisely” unless profoundly low IgG (often with immeasurable IgA) [39]. By contrast, children transplanted for PID have variable B‐cell immune reconstitution and continue immunoglobulin replacement therapy until functional B‐cell reconstitution is documented.