INFECTION AFTER BONE MARROW TRANSPLANTATION "ESSAY"

Abstract

BMT is an important and efficient treatment procedure against many haematologic and non haematologic disorders.

Disturbances in immunity, which will accompany heavy chemotherapy given for conditioning before Bone marrow transplantation, will lead to immunodeficiency (early, mid, late recovery periods).

The incidence of catching severe infections althrough these periods of immunodeficiency is very high either from internal factors or external factors.

Severe infections will affect by a way or another the outcome of bone marrow transplantation procedures either by severe morbidity or mortality. Most transplantation associated deaths have been attributable to either infection or graft versus host disease (GVHD), or a combination of both.

Most severe infections occur during the first six months after the transplant but infectious complications can be fatal many years later.

Major efforts are made in transplant units to limit the impact of these severe infections on the transplant recipients.

' This shows that there is an urgent need for proper anticipation, early detection, proper management and monitoring of infected post bone marrow transplant patients. Therefore infection protection policies should include control of the physical environment, preventive strategies, good diagnostic techniques and treatment strategies against important pathogens. However shifts in patterns of opportunistic pathogens, changing antimicrobial susceptibility, changes in host immunodeficiency due to new immuno-suppressive regimens for prevention & treatment of GVHD, introduction of new preparative regimens and the increasing use of matched unrelated donors continue to pose new and evolving challenges for the management of infectious complications.