Abstract:

BACKGROUND： Hematopoietic stem cell （HSC） transplantation has been widely applied in the clinical practice, and the postoperative infection is the key point for the transplantation. OBJECTIVE： To investigate the characteristics, prevention and treatment of infection after HSC transplantation, and reduce incidence and death rate of post-HSC transplantation infection. RETRIEVE STRATEGY： English articles referring to HSC transplantation and postoperative infection were obtained from a computerised search of Medline from January 1994 to May 2007 using a combined keyword of ＂hematopoietic stem cell transplantation and infection＂. A search of Chinese articles was also undertaken on the Chinese Journal Full-text Database between January 1994 and May 2007, with the key words of ＂hematopoietic stem cell transplantation, infection, prevention and treatment＂. Inclusive criterion： randomised controlled trial; experiment or clinical study with a control group. The repeated studies were excluded. LITERATURE EVALUATION： A total of 212 articles were collected, and 126 ones related to about HSC transplantation infection were selected for full texts, 29 experimental studies met the inclusion criteria were included, and reported the reasons, methods, characteristic, types, prevention and treatment of infection after HSC transplantation in 324 patients and 140 experimental animals. Then those were excluded id they were not relevant at all or not relevant enough. DATA SYNTHESIS： The onset of post-HSC transplantation infection is occult. Due to low immunity of the patients, the infections are hard to be controlled. The types of pathogens vary at different stages after the transplantation. Bacterial infection is common and can happen any time after the transplantation. Fungal and virus infections are powerful and fatal. Therefore, it is crucial to prevent and treat post-HSC transplantation. Treatment of infection includes preventive treatment, preemptive treatment, empirical treatment, and targeting treatment. CONCLUSION： Post-HSC transplantation infection has been recognised as a main reason affecting the outcome of transplantation. Early diagnosis and proper treatment would be the key for successful transplantation.[著者文摘]