Prophylaxis of infection rather than therapeutic intervention must be the major theme of bone marrow transplantation in the 1990s. The use of quinolones has at last brought major rewards in this endeavor, with potent activity against gram-negative organisms, although infections due to gram-positive cocci remain a major problem. Fungal infection is still associated with a poor outcome, but it is often a marker of underlying complications of the transplant. Prophylaxis against some Candida species is now secure. For therapy of invasive fungal infection, liposomally entrapped amphotericin B appears to overcome the toxicity problems associated with conventional therapy. Current research is exploring ways of accelerating recovery of the immune system, which may also facilitate opportunities for vaccination. However, the most important developments at present are the application of colony-stimulating factors in speeding marrow recovery and improvements in marrow transplantation leading to reduced toxicity and reduced graft-versus-host disease.
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McWhinney et al. (1992) studied this question.