Infectious Complications after Allogeneic Peripheral Blood Stem Cell Transplantation Compared with Bone Marrow Transplantation

We compared the incidence of bacterialfungaland cytomegalovirus (CMVinfections after peripheral blood stem cell transplantation (PBSCTwith that after bone marrow transplantation (BMT. Thirteen patients who received PBSCT and 23 patients who received BMT were analyzed from May 1997 through July 2002. We evaluated the time to neutrophil and platelet engraftment and the incidence of acute and chronic graft-versus-host disease(GvHD. We also monitored CMV infections with the pp65 antigen assay. The time to neutrophil engraftment was significantly less after PBSCT than after BMT (p＝0.01. However the time to platelet engraftment and the incidences of acute and chronic GvHD bacteremia and fungal infection did not differ between PBSCT and BMT. The incidence of CMV infection during the early-phase was significantly lower after PBSCT than after BMT (33% vs 74%p＝0.04. Howeverthe cumulative incidence of CMV infection including late-phase infection did not differ significantly between PBSCT and BMT. These results indicate that neutrophil engraftment occurs sooner after PBSCT than after BMT and that early-phase CMV infection is less common after PBSCT. Howeverlate-phase CMV infec‑ tions are common after PBSCT. Thereforeextended antigenemia surveillance is recommended for patients who receive PBSCT. (Jikeikai Med J 2003;50:115-24