Supportive Care During Pediatric Hematopoietic Stem Cell Transplantation: Prevention of Infections. A Report From Workshops on Supportive Care of the Paediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT)

Marianne Ifversen; Roland Meisel; Petr Sedlacek; Krzysztof Kalwak; Luisa Sisinni; Daphna Hutt; Thomas Lehrnbecher; Adriana Balduzzi; Tamara Diesch; Andrea Jarisch; Tayfun Güngör; Jerry Stein; Isaac Yaniv; Halvard Bonig; Michaela Kuhlen; Marc Ansari; Tiago Nava; Jean-Hugues Dalle; Cristina Diaz-de-Heredia; Eugenia Trigoso; Ulrike Falkenberg; Mihaela Hartmann; Marco Deiana; Marta Canesi; Chiara Broggi; Alice Bertaina; Brenda Gibson; Gergely Krivan; Kim Vettenranta; Toni Matic; Jochen Buechner; Anita Lawitschka; Christina Peters; Akif Yesilipek; Koray Yalçin; Giovanna Lucchini; Shahrzad Bakhtiar; Dominik Turkiewicz; Riitta Niinimäki; Jacek Wachowiak; Simone Cesaro; Arnaud Dalissier; Selim Corbacioglu; Andre Manfred Willasch; Peter Bader

doi:10.3389/fped.2021.705179

Supportive Care During Pediatric Hematopoietic Stem Cell Transplantation: Prevention of Infections. A Report From Workshops on Supportive Care of the Paediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT)

Front Pediatr. 2021 Jul 29:9:705179. doi: 10.3389/fped.2021.705179. eCollection 2021.

Authors

Marianne Ifversen¹, Roland Meisel², Petr Sedlacek³, Krzysztof Kalwak⁴, Luisa Sisinni⁵, Daphna Hutt⁶, Thomas Lehrnbecher⁷, Adriana Balduzzi⁸, Tamara Diesch⁹, Andrea Jarisch¹⁰, Tayfun Güngör¹¹, Jerry Stein¹², Isaac Yaniv¹², Halvard Bonig¹³, Michaela Kuhlen¹⁴, Marc Ansari^{15

16}, Tiago Nava^{15

16}, Jean-Hugues Dalle¹⁷, Cristina Diaz-de-Heredia¹⁸, Eugenia Trigoso¹⁹, Ulrike Falkenberg²⁰, Mihaela Hartmann²⁰, Marco Deiana²¹, Marta Canesi⁸, Chiara Broggi⁸, Alice Bertaina^{22

23}, Brenda Gibson²⁴, Gergely Krivan²⁵, Kim Vettenranta²⁶, Toni Matic²⁷, Jochen Buechner²⁸, Anita Lawitschka²⁰, Christina Peters²⁰, Akif Yesilipek²⁹, Koray Yalçin³⁰, Giovanna Lucchini³¹, Shahrzad Bakhtiar¹⁰, Dominik Turkiewicz³², Riitta Niinimäki³³, Jacek Wachowiak³⁴, Simone Cesaro³⁵, Arnaud Dalissier³⁶, Selim Corbacioglu³⁷, Andre Manfred Willasch¹⁰, Peter Bader¹⁰

Affiliations

¹ Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
² Division of Pediatric Stem Cell Therapy, Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany.
³ Department of Pediatric Hematology and Oncology, Hospital Motol, Charles University, Prague, Czechia.
⁴ Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
⁵ Pediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Unit, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
⁶ Division of Pediatric Hematology, Oncology and Bone Marrow Transplantation, The Edmond and Lily Safra Children's Hospital, Tel Aviv, Israel.
⁷ Division for Pediatric Hematology and Oncology, Hospital for Children and Adolescents, University Hospital, Goethe University, Frankfurt am Main, Germany.
⁸ Clinica Pediatrica Università degli Studi di Milano Bicocca, Fondazione Monza e Brianza per il Bambino e la sua Mamma, Ospedale San Gerardo, Monza, Italy.
⁹ Division of Pediatric Hematology-Oncology, University Children's Hospital of Basel, Basel, Switzerland.
¹⁰ Division for Stem Cell Transplantation, Immunology and Intensive Care Medicine, Hospital for Children and Adolescents, University Hospital, Goethe University, Frankfurt am Main, Germany.
¹¹ Department of Hematology, Immunology, Oncology and Stem Cell Transplantation, University Children's Hospital Zürich, Zurich, Switzerland.
¹² Division of Pediatric Hematoloy-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.
¹³ Institute for Transfusion Medicine and Immunohematology of Goethe University, German Red Cross Blood Service Baden-Württemberg-Hessen, Frankfurt am Main, Germany.
¹⁴ Paediatrics and Adolescent Medicine, Medical Faculty, University of Augsburg, Augsburg, Germany.
¹⁵ Division of Pediatric Hematology-Oncology, University Hospital of Geneva, Geneva, Switzerland.
¹⁶ Cansearch Research Platform in Paediatric Oncology and Haematology, Department of Paediatrics, Gynaecology and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
¹⁷ Hematology and Immunology Department, Robert-Debre Hospital, Assistance Publique-Hopitaux de Paris and University of Paris, Paris, France.
¹⁸ Department of Pediatric Oncology and Hematology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
¹⁹ Paediatric Transplant Unit, Hospital University and Polytechnic, Hospital LA FE, Valencia, Spain.
²⁰ Stem Cell Transplantation-Unit, Department of Pediatrics, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.
²¹ Paediatric Haematology-Oncology Department, Istituto di Ricovero e Cura a Carattere Scientifico G Gaslini, Genova, Italy.
²² Department of Pediatric Hematology-Oncology and Cell and Gene Therapy, Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Bambino Gesù, Rome, Italy.
²³ Division of Stem Cell Transplantation and Regenerative Medicine, Department of Pediatrics, School of Medicine, Stanford University, Stanford, CA, United States.
²⁴ Department of Paediatric Haematology-Oncology, Royal Hospital for Children, Glasgow, United Kingdom.
²⁵ Central Hospital of Southern Pest, National Institute of Hematology and Infectious Disease, Budapest, Hungary.
²⁶ Children's Hospital and Pediatric Research Center, University of Helsinki, Helsinki, Finland.
²⁷ Department of Pediatrics, University Hospital Center Zagreb, Zagreb, Croatia.
²⁸ Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway.
²⁹ Department of Pediatric Hematology and Pediatric Stem Cell Transplantation Unit, Antalya and Göztepe Medicalpark Hospitals, Antalya, Turkey.
³⁰ Department of Pediatric Bone Marrow Transplantation Unit, Medicalpark Göztepe Hospital, Istanbul, Turkey.
³¹ Department of Bone Marrow Transplantation, Great Ormond Street Hospital for Children, National Health Service Foundation Trust, London, United Kingdom.
³² Division of Molecular Hematology, Lund University, Lund, Sweden.
³³ Department of Pediatrics, Oulu University Hospital, Oulu, Finland.
³⁴ Department of Pediatric Oncology, Hematology and Hematopoietic Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
³⁵ Pediatric Hematology Oncology, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
³⁶ European Society for Blood and Marrow Transplantation Paris Office, Hôpital Saint Antoine, Paris, France.
³⁷ Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital of Regensburg, Regensburg, Germany.

Abstract

Specific protocols define eligibility, conditioning, donor selection, graft composition and prophylaxis of graft vs. host disease for children and young adults undergoing hematopoietic stem cell transplant (HSCT). However, international protocols rarely, if ever, detail supportive care, including pharmaceutical infection prophylaxis, physical protection with face masks and cohort isolation or food restrictions. Supportive care suffers from a lack of scientific evidence and implementation of practices in the transplant centers brings extensive restrictions to the child's and family's daily life after HSCT. Therefore, the Board of the Pediatric Diseases Working Party (PDWP) of the European Society for Blood and Marrow Transplantation (EBMT) held a series of dedicated workshops since 2017 with the aim of initiating the production of a set of minimal recommendations. The present paper describes the consensus reached within the field of infection prophylaxis.

Keywords: allogeneic hematological stem cell transplantation; antibiotic prophylactic therapy; children; infection precaution; vaccination.

Copyright © 2021 Ifversen, Meisel, Sedlacek, Kalwak, Sisinni, Hutt, Lehrnbecher, Balduzzi, Diesch, Jarisch, Güngör, Stein, Yaniv, Bonig, Kuhlen, Ansari, Nava, Dalle, Diaz-de-Heredia, Trigoso, Falkenberg, Hartmann, Deiana, Canesi, Broggi, Bertaina, Gibson, Krivan, Vettenranta, Matic, Buechner, Lawitschka, Peters, Yesilipek, Yalçin, Lucchini, Bakhtiar, Turkiewicz, Niinimäki, Wachowiak, Cesaro, Dalissier, Corbacioglu, Willasch and Bader.