Infectious complications within the first year after nonmyeloablative allogeneic peripheral blood stem cell transplantation

Nonmyeloablative peripheral blood stem cell transplantation (PBSCT) is a no vel therapeutic strategy for patients with malignant and non-malignant hema tologic diseases. Infectious complications of this procedure have not been previously well described. Data on 12 patients transplanted at a tertiary c are center were collected prospectively and verified retrospectively. Neutr openia developed in a third of patients, lasting for a median of 5 days. Al l patients developed some degree of graft-versus-host disease, as intended. Most patients achieved full chimerism by week 5. Bacterial infections occu rred in two patients (17%). Cytomegalovirus (CMV) viremia occurred in five patients (42%) at a median of 80 days; none had received CMV prophylaxis. V iremia was associated with fever and fatigue in three patients, possible ga strointestinal involvement in one patient and was asymptomatic in one patie nt. All viremic patients responded to intravenous ganciclovir therapy. No f ungal infections were documented. No patients died as a result of infection . The incidence of CMV viremia in our patients was high, but the incidence of invasive disease due to CMV was low. The best strategy to prevent CMV in patients undergoing nonmyeloablative PBSCT remains to be determined, but s trategies employed in traditional allogeneic bone marrow transplantation sh ould be considered in these patients.