Evaluation of significant clinical signs and therapy characteristics in patients with CMV infection after allogeneic stem cell transplantation

Cellular Therapy and Transplantation

Anna V. Akimova¹  Vladimir N. Vavilov¹  Ildar M. Barkhatov¹  Svetlana S. Emelyanova¹  Ludmila S. Zubarovskaya¹ 

关键词: allogeneic HSCT;    infectious complications;    CMV;   

DOI  :  10.3205/ctt-2010-No9-abstract80

学科分类：肿瘤学

来源: Universitaetsklinikum Hamburg - Eppendorf / University Medical Center Hamburg - Eppendorf

【 摘 要 】

Background:Cytomegalovirus(CMV)reactivationisamongthemostimportantcomplicationsthatdeterminemorbidityandmortalityinrecipientsofallogeneichematopoieticstemcelltransplants(HSCT).Objective:TheaimofourstudywastoevaluatesignificantclinicalparametersandtreatmentcompoundsinfluencingCMVreactivation.Materialandmethods:Samplesofperipheralbloodandbonemarrowwerereceivedfrom96patientsafterallo-HSCT(59matchedunrelated,32relatedand7haploidenticaldonors).Nonmyeloablativeconditioningwasusedin61cases,andmyeloablativein35cases.Allpatientstransplantedfromunrelatedorhaploidenticaldonorsreceivedantithymocyteglobulin(ATG).QuantitativeRT-PCRwasusedtoevaluateviralloadeitherinblood/bonemarroworinplasma.Results:CMV-reactivationwasobservedin85%ofpatientsinearly,andin15%ofpatientsinthelatepost-transplantperiod.Thereactivationratedoesnotdependontheconditioningregimenintensity,butwassignificantlyhigherinpatientsreceivingHSCTfromunrelatedthanfrommatchedrelateddonors(75%vs.40%).Prophylaxisofgraft-versus-hostdiseasewithATGwasassociatedwithanincreasedriskofreactivation(70%vs.34%)andhigherviralload.LowerreactivationrateswereobservedinbothCMVIgG-negativedonorandrecipientpairs(only18%).Conclusion:CMV-reactivationinallogeneicHSCTrecipientswasmorefrequentintheearlypost-transplantperiodanddependsondonorcompatibility,theCMVserostatusofdonorandrecipient,andATGuse.ThesefactorsshouldbetakenintoaccountwhileplanningthemonitoringandtherapyforCMVinfection.

【 授权许可】

Unknown