Tags

Type your tag names separated by a space and hit enter

Cytomegalovirus viremia, viruria and disease after autologous peripheral blood stem cell transplantation: no need for surveillance.
Bone Marrow Transplant. 1999 Jul; 24(1):69-73.BM

Abstract

A retrospective evaluation of 200 consecutive recipients of autologous peripheral blood stem cell transplantation (PBSCT) was conducted to ascertain the incidence, risk factors, clinical features, complications, and outcome of cytomegalovirus (CMV) infection. A total of 26 patients (13%) developed CMV viremia (n = 5), DNAemia (n = 3), viruria (n = 18) and/or disease (n = 3) at a median of 45 days following stem cell infusion. None of the patients underwent surveillance testing for CMV. A diagnosis was established by culture and polymerase chain reaction of blood, urine or other tissue samples submitted when patients exhibited clinical features suggestive of CMV infection. Cytomegalovirus seropositivity prior to transplantation was the only statistically significant risk factor predicting subsequent identification of CMV (P < 0.001). The symptoms were severe enough in 23 patients to warrant treatment with intravenous ganciclovir. Three patients developed CMV disease; two developed fatal CMV pneumonia and one developed CMV gastritis which responded to antiviral treatment. Clinical signs and symptoms as well as viremia and viruria resolved with (20 patients) and without (three patients) treatment in the remaining individuals. All instances of CMV viremia, DNAemia, viruria and disease occurred within 3 months of stem cell infusion. These results demonstrate that CMV is a common pathogen after autologous PBSCT and may result in fatality in rare instances. Surveillance programs appear to be neither useful nor cost-effective. Diagnostic evaluation should be performed only in patients exhibiting suspicious clinical features and antiviral chemotherapy should be administered for persistent and severe signs and symptoms.

Authors+Show Affiliations

Bone Marrow Transplant Program, University of Connecticut Health Center, Farmington 06030, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10435738

Citation

Bilgrami, S, et al. "Cytomegalovirus Viremia, Viruria and Disease After Autologous Peripheral Blood Stem Cell Transplantation: No Need for Surveillance." Bone Marrow Transplantation, vol. 24, no. 1, 1999, pp. 69-73.
Bilgrami S, Aslanzadeh J, Feingold JM, et al. Cytomegalovirus viremia, viruria and disease after autologous peripheral blood stem cell transplantation: no need for surveillance. Bone Marrow Transplant. 1999;24(1):69-73.
Bilgrami, S., Aslanzadeh, J., Feingold, J. M., Bona, R. D., Clive, J., Dorsky, D., Edwards, R. L., & Tutschka, P. J. (1999). Cytomegalovirus viremia, viruria and disease after autologous peripheral blood stem cell transplantation: no need for surveillance. Bone Marrow Transplantation, 24(1), 69-73.
Bilgrami S, et al. Cytomegalovirus Viremia, Viruria and Disease After Autologous Peripheral Blood Stem Cell Transplantation: No Need for Surveillance. Bone Marrow Transplant. 1999;24(1):69-73. PubMed PMID: 10435738.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus viremia, viruria and disease after autologous peripheral blood stem cell transplantation: no need for surveillance. AU - Bilgrami,S, AU - Aslanzadeh,J, AU - Feingold,J M, AU - Bona,R D, AU - Clive,J, AU - Dorsky,D, AU - Edwards,R L, AU - Tutschka,P J, PY - 1999/8/6/pubmed PY - 1999/8/6/medline PY - 1999/8/6/entrez SP - 69 EP - 73 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 24 IS - 1 N2 - A retrospective evaluation of 200 consecutive recipients of autologous peripheral blood stem cell transplantation (PBSCT) was conducted to ascertain the incidence, risk factors, clinical features, complications, and outcome of cytomegalovirus (CMV) infection. A total of 26 patients (13%) developed CMV viremia (n = 5), DNAemia (n = 3), viruria (n = 18) and/or disease (n = 3) at a median of 45 days following stem cell infusion. None of the patients underwent surveillance testing for CMV. A diagnosis was established by culture and polymerase chain reaction of blood, urine or other tissue samples submitted when patients exhibited clinical features suggestive of CMV infection. Cytomegalovirus seropositivity prior to transplantation was the only statistically significant risk factor predicting subsequent identification of CMV (P < 0.001). The symptoms were severe enough in 23 patients to warrant treatment with intravenous ganciclovir. Three patients developed CMV disease; two developed fatal CMV pneumonia and one developed CMV gastritis which responded to antiviral treatment. Clinical signs and symptoms as well as viremia and viruria resolved with (20 patients) and without (three patients) treatment in the remaining individuals. All instances of CMV viremia, DNAemia, viruria and disease occurred within 3 months of stem cell infusion. These results demonstrate that CMV is a common pathogen after autologous PBSCT and may result in fatality in rare instances. Surveillance programs appear to be neither useful nor cost-effective. Diagnostic evaluation should be performed only in patients exhibiting suspicious clinical features and antiviral chemotherapy should be administered for persistent and severe signs and symptoms. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/10435738/Cytomegalovirus_viremia_viruria_and_disease_after_autologous_peripheral_blood_stem_cell_transplantation:_no_need_for_surveillance_ L2 - https://doi.org/10.1038/sj.bmt.1701827 DB - PRIME DP - Unbound Medicine ER -