High rate of secondary viral and bacterial infections in patients undergoing allogeneic bone marrow mini-transplantation

New approaches using nonmyeloablative-conditioning regimens have been devel oped to cause minimal procedure-related toxicity. Such novel therapeutic op tions are being explored with good preliminary results concerning feasibili ty and engraftment. However many aspects remain under-evaluated, and few da ta are available about viral and nonviral infections after these highly imm unosuppressive regimens, We present our preliminary data on 21 patients rec eiving a highly immunosuppressive conditioning strategy, focusing on early infectious complications, Early viral infections before day 45, especially CMV, occurred at a high rate (65%). Furthermore, 33% of patients presented with late bacterial infections (predominately gram negative) although they were not neutropenic compared to conventional conditioning regimens. Althou gh there is presently real interest in these new conditioning regimens whic h result in reduced immediate transplant-related mortality, it is important that investigators be aware of these pitfalls which may secondarily increa se transplant toxicity, Further studies are needed to confirm these finding s.