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Use of PCR serum in diagnosing and monitoring cytomegalovirus reactivation in bone marrow transplant recipients.
Int J Hematol. 1999 Feb; 69(2):105-11.IJ

Abstract

We previously reported that the use of polymerase chain reaction (PCR) in detecting cytomegalovirus (CMV) DNA in serum (sPCR) enables the detection of CMV viremia, which has not been possible with other methods. In this study, the clinical usefulness of sPCR was investigated by comparison with the results of three other diagnostic methods, i.e., antigenemia assay (AG), shell vial culture test (shell vial), and complement-fixing (CF) antibody titer. The present study included 26 patients with hematological diseases who had undergone allogeneic bone marrow transplantation (BMT). A total of 347 samples were collected, and the results of the sPCR and AG methods were in agreement in 91.1% of the samples. When a subject was positive in both the sPCR and AG tests, and the other two tests (shell vial and CF) were also positive, CMV reactivation was surmised as definite. When only the result of the shell vial test or the CF test was positive, these results were taken as false-positives. The time at which the samples became positive in each of these four tests was 7.5 weeks post-BMT for sPCR, 7.0 weeks post-BMT for the AG test, 7.4 weeks post-BMT for the shell vial test, and 9.7 weeks post-BMT for the CF test. Thus, it was found that samples became positive at almost the same time for the sPCR, AG, and shell vial tests. Interstitial pneumonitis (IP) due to CMV developed in 3 subjects. These cases were positive in the sPCR, AG, and shell vial tests prior to the manifestation of symptoms of IP. The CF test did not become positive until after the onset of the disease. As the IP due to CMV was controlled with treatment, the sPCR and AG tests became negative. With the shell vial and CF tests, on the other hand, the test results continued to be positive even after the IP was cured. These findings demonstrate that the sPCR test method--like the AG test--yields few false-positive results. Therefore, the sPCR method is useful in early diagnosis of reactivation of CMV and for evaluation of the efficacy of therapy administered for IP. In addition, sPCR can be performed simultaneously on a large number of samples, and the evaluation of the test results is simple. We conclude that the sPCR test may be superior to the three other diagnostic methods for evaluation of serum samples from multiple institutions.

Authors+Show Affiliations

Fourth Department of Internal Medicine, Sapporo Medical University, School of Medicine, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10071460

Citation

Matsunaga, T, et al. "Use of PCR Serum in Diagnosing and Monitoring Cytomegalovirus Reactivation in Bone Marrow Transplant Recipients." International Journal of Hematology, vol. 69, no. 2, 1999, pp. 105-11.
Matsunaga T, Sakamaki S, Ishigaki S, et al. Use of PCR serum in diagnosing and monitoring cytomegalovirus reactivation in bone marrow transplant recipients. Int J Hematol. 1999;69(2):105-11.
Matsunaga, T., Sakamaki, S., Ishigaki, S., Kohda, K., Takeda, M., Katoh, J., Kuroda, H., Hirayama, Y., Kusakabe, T., Akiyama, T., Kuga, T., Niitsu, Y., Masaoka, T., Sagawa, T., & Matsumoto, Y. (1999). Use of PCR serum in diagnosing and monitoring cytomegalovirus reactivation in bone marrow transplant recipients. International Journal of Hematology, 69(2), 105-11.
Matsunaga T, et al. Use of PCR Serum in Diagnosing and Monitoring Cytomegalovirus Reactivation in Bone Marrow Transplant Recipients. Int J Hematol. 1999;69(2):105-11. PubMed PMID: 10071460.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of PCR serum in diagnosing and monitoring cytomegalovirus reactivation in bone marrow transplant recipients. AU - Matsunaga,T, AU - Sakamaki,S, AU - Ishigaki,S, AU - Kohda,K, AU - Takeda,M, AU - Katoh,J, AU - Kuroda,H, AU - Hirayama,Y, AU - Kusakabe,T, AU - Akiyama,T, AU - Kuga,T, AU - Niitsu,Y, AU - Masaoka,T, AU - Sagawa,T, AU - Matsumoto,Y, PY - 1999/3/11/pubmed PY - 1999/3/11/medline PY - 1999/3/11/entrez SP - 105 EP - 11 JF - International journal of hematology JO - Int J Hematol VL - 69 IS - 2 N2 - We previously reported that the use of polymerase chain reaction (PCR) in detecting cytomegalovirus (CMV) DNA in serum (sPCR) enables the detection of CMV viremia, which has not been possible with other methods. In this study, the clinical usefulness of sPCR was investigated by comparison with the results of three other diagnostic methods, i.e., antigenemia assay (AG), shell vial culture test (shell vial), and complement-fixing (CF) antibody titer. The present study included 26 patients with hematological diseases who had undergone allogeneic bone marrow transplantation (BMT). A total of 347 samples were collected, and the results of the sPCR and AG methods were in agreement in 91.1% of the samples. When a subject was positive in both the sPCR and AG tests, and the other two tests (shell vial and CF) were also positive, CMV reactivation was surmised as definite. When only the result of the shell vial test or the CF test was positive, these results were taken as false-positives. The time at which the samples became positive in each of these four tests was 7.5 weeks post-BMT for sPCR, 7.0 weeks post-BMT for the AG test, 7.4 weeks post-BMT for the shell vial test, and 9.7 weeks post-BMT for the CF test. Thus, it was found that samples became positive at almost the same time for the sPCR, AG, and shell vial tests. Interstitial pneumonitis (IP) due to CMV developed in 3 subjects. These cases were positive in the sPCR, AG, and shell vial tests prior to the manifestation of symptoms of IP. The CF test did not become positive until after the onset of the disease. As the IP due to CMV was controlled with treatment, the sPCR and AG tests became negative. With the shell vial and CF tests, on the other hand, the test results continued to be positive even after the IP was cured. These findings demonstrate that the sPCR test method--like the AG test--yields few false-positive results. Therefore, the sPCR method is useful in early diagnosis of reactivation of CMV and for evaluation of the efficacy of therapy administered for IP. In addition, sPCR can be performed simultaneously on a large number of samples, and the evaluation of the test results is simple. We conclude that the sPCR test may be superior to the three other diagnostic methods for evaluation of serum samples from multiple institutions. SN - 0925-5710 UR - https://www.unboundmedicine.com/medline/citation/10071460/Use_of_PCR_serum_in_diagnosing_and_monitoring_cytomegalovirus_reactivation_in_bone_marrow_transplant_recipients_ L2 - https://medlineplus.gov/cytomegalovirusinfections.html DB - PRIME DP - Unbound Medicine ER -