The Preengraftment Period

The preengraftment period commences with the initiation of the preparative regimen and ends at the time of engraftment. This usually occurs by about day 20 in autologous HSCT recipients and by day 30 in allo-geneic HSCT recipients, but may vary depending upon the conditioning regimen and the underlying disease. The presence of indwelling intravascular devices, mucositis of the mouth and gastrointestinal tract, neu-tropenia, and lymphopenia are the major defects in host defense that occur during the preengraftment period. These are present in both autologous and allo-geneic HSCT recipients, and thus the types of infectious complications seen in these respective groups are similar; however, the shorter duration of neutropenia in autologous HSCT recipients is responsible for a lower incidence of infectious complications in these individuals.

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