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Selective digestive decontamination (SDD) with the oral, non-absorbable antimicrobial substances gentamicin, vancomycin and amphotericin B was optionally used at our institution to reduce the risk of gastrointestinal tract derived infections in multiple myeloma (MM) patients undergoing high-dose chemotherapy with subsequent autologous stem cell transplantation (HDCT/ASCT). The majority of patients received sulfamethoxazole-trimethoprim as pneumocystis pneumonia prophylaxis. From 203 patients receiving their first HDCT/ASCT between 2009 and 2015, we compared retrospectively 90 patients receiving SDD to 113 patients not receiving SDD. The administration of SDD was associated with a reduction of bacterial infections after HDCT/ASCT (overall: 8% versus 24%, p =.002; gram-negative pathogens: 1% versus 11%, p =.006) and less use of systemic antibiotics (62% versus 77%, p =.022). Omission of SDD was an independent risk factor for developing neutropenic fever and bloodstream infections. SDD could be an option to reduce bacterial infections in patients undergoing HDCT/ASCT that needs to be tested in prospective trials. [ABSTRACT FROM AUTHOR]

The article focuses on a case study of a 41-year-old female patient who developed Epstein-Barr virus (EBV)-associated B-cells post-transplant lymphoproliferative disorder (PTLD). Topics discussed include treatment of PTLD with immuno-chemotherapy, selection of chemotherapy on the basis of type of lymphoma, use of lenalidomide monotherapy for treatment of EBV-associated PTLD, effect of the drug in T-cell PTLD, and use of lenalidomide as a safe option for PTLD's treatment.