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Background  Serious infections are common in patients undergoing autologous stem cell transplantation (ASCT) mainly because of the effects of immunosuppression. The innate immune system plays an important role in the defense against different infections. Mannose binding lectin (MBL) is a central molecule of the innate immune system. There are several promoter polymorphisms and structural variants of the  MBL2  gene that encodes for this protein. These variants produce low levels of MBL and have been associated with an increased risk for infections.    Methods  Prospective cohort study. The incidence, severity of infections and mortality in 72 consecutive patients with hematologic diseases who underwent ASCT between February 2006 and June 2008 in a tertiary referral center were analyzed according to their  MBL2  genotype. INNO-LiPA  MBL2  was used for  MBL2  gene amplification and genotyping. Relative risks (RR) (IC95%) as measure of association were calculated. Multivariate analysis was performed using logistic regression.    Results  A statistically significant higher number of fungal infections was found in patients with  MBL2  variants causing low MBL levels (21.1%versus1.9%, p=0.016). In this  MBL2  variant group infection was more frequently the cause of mortality than in the  MBL2  wild-type group (p=0.05). Although not statistically significant, there was a higher incidence of major infections in the  MBL2  variant group as well as a higher number of infections caused by gram-positive bacteria.    Conclusions  Low-producer  MBL2  genotypes were associated with an increased number of fungal infections in ASCT patients, which would suggest that MBL has a protective role against such infections. ASCT patients with  MBL2  variant genotypes are more likely to die as a result of an infection.

Mannose-binding lectin gene variants and infections in patients receiving autologous stem cell transplantation