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Trimethoprim/sulfamethoxazole prophylaxis impairs function of mobilised autologous peripheral blood stem cells

Bone Marrow Transplantation volume 26, pages 815–816 (2000)Cite this article

The combination of trimethoprim and sulfamethoxazole (TMP/SMX) is widely used as antimicrobial prophylaxis in cancer patients receiving chemotherapy or undergoing haematopoietic stem cell transplantation. In the early 1980s, there was considerable controversy regarding a potential myelotoxic effect of TMP/SMX as reflected in a series of letters to Lancet.123 In 1995, TMP/SMX prophylaxis was shown to delay neutrophil recovery after bone marrow transplantation in two clinical studies.45 We now report our preliminary evidence that TMP/SMX prophylaxis may impair the colony growth and engraftment potential of chemotherapy-mobilised autologous peripheral blood stem cells.

Three patients with high-grade non-Hodgkin’s lymphoma were treated with a sequential high-dose chemotherapy protocol (Mega-CHOEP) consisting of four cycles of CHOEP (cyclophosphamide, adriamycin, vincristine, etoposide and prednisolone) in escalating doses together with G-CSF. After cycles 1–3, stem cells were harvested to be re-infused after the second, third and fourth chemotherapy course to accelerate haematopoietic recovery. During cycle 1 all patients received 160 mg TMP and 800 mg SMX once a day as antimicrobial prophylaxis. No other medication known to influence stem cell mobilisation or growth was administered.

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  1. University of Cologne, I Dept of Medicine, 50924 Cologne, Germany

    M Fuchs, C Scheid, A Schulz, V Diehl & D Söhngen

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  1. M Fuchs
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  2. C Scheid
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  3. A Schulz
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  4. V Diehl
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  5. D Söhngen
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Fuchs, M., Scheid, C., Schulz, A. et al. Trimethoprim/sulfamethoxazole prophylaxis impairs function of mobilised autologous peripheral blood stem cells. Bone Marrow Transplant 26, 815–816 (2000). https://doi.org/10.1038/sj.bmt.1702586

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