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Pre-emptive treatment of CMV DNAemia in paediatric stem cell transplantation: the impact of recipient and donor CMV serostatus on the incidence of CMV disease and CMV-related mortality.
Bone Marrow Transplant. 2003 May; 31(9):803-8.BM

Abstract

Cytomegalovirus (CMV) DNAemia was detected by PCR in 30/125 (24%) consecutive paediatric patients undergoing allogeneic stem cell transplantation. All patients with CMV DNAemia received pre-emptive ganciclovir until two consecutive negative results were obtained. CMV-IgG-positive patients (R+) had a significantly increased risk of DNAemia as compared to CMV-IgG-negative (R-) patients (62% vs 8%) P<0.0001. The incidence of DNAemia was 71% (10/14) in R+ transplanted from seronegative donors (D-) compared to 54% (13/32) in those transplanted from seropositive donors (D+). Of 30 (40%) children with DNAemia, 12 developed CMV disease despite pre-emptive treatment. The overall incidence of disease was 0% (0/59) for R-/D-, 9% (3/23) for R+/D+, 7% (2/29) for R-/D+ and 57% (8/14) for R+/D-. In patients with DNAemia, 4/20 (20%) patients with D+ and 8/10 (80%) with D- became symptomatic. In the multivariate analysis of both groups, patients at risk (R+ and/or D+) and patients with DNAemia, a negative donor serostatus was the only factor associated with a significantly increased incidence of disease. Seven of 9 patients with lethal CMV disease had received CMV-IgG-negative grafts. The data suggest that in CMV seropositive recipients donor CMV seropositivity is associated with a reduced incidence of CMV disease and a favourable outcome following pre-emptive treatment.

Authors+Show Affiliations

St. Anna Children's Hospital, Vienna, Austria.No 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)

Journal Article

Language

eng

PubMed ID

12732888

Citation

Matthes-Martin, S, et al. "Pre-emptive Treatment of CMV DNAemia in Paediatric Stem Cell Transplantation: the Impact of Recipient and Donor CMV Serostatus On the Incidence of CMV Disease and CMV-related Mortality." Bone Marrow Transplantation, vol. 31, no. 9, 2003, pp. 803-8.
Matthes-Martin S, Lion T, Aberle SW, et al. Pre-emptive treatment of CMV DNAemia in paediatric stem cell transplantation: the impact of recipient and donor CMV serostatus on the incidence of CMV disease and CMV-related mortality. Bone Marrow Transplant. 2003;31(9):803-8.
Matthes-Martin, S., Lion, T., Aberle, S. W., Fritsch, G., Lawitschka, A., Bittner, B., Frommlet, F., Gadner, H., & Peters, C. (2003). Pre-emptive treatment of CMV DNAemia in paediatric stem cell transplantation: the impact of recipient and donor CMV serostatus on the incidence of CMV disease and CMV-related mortality. Bone Marrow Transplantation, 31(9), 803-8.
Matthes-Martin S, et al. Pre-emptive Treatment of CMV DNAemia in Paediatric Stem Cell Transplantation: the Impact of Recipient and Donor CMV Serostatus On the Incidence of CMV Disease and CMV-related Mortality. Bone Marrow Transplant. 2003;31(9):803-8. PubMed PMID: 12732888.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-emptive treatment of CMV DNAemia in paediatric stem cell transplantation: the impact of recipient and donor CMV serostatus on the incidence of CMV disease and CMV-related mortality. AU - Matthes-Martin,S, AU - Lion,T, AU - Aberle,S W, AU - Fritsch,G, AU - Lawitschka,A, AU - Bittner,B, AU - Frommlet,F, AU - Gadner,H, AU - Peters,C, PY - 2003/5/7/pubmed PY - 2004/2/21/medline PY - 2003/5/7/entrez SP - 803 EP - 8 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 31 IS - 9 N2 - Cytomegalovirus (CMV) DNAemia was detected by PCR in 30/125 (24%) consecutive paediatric patients undergoing allogeneic stem cell transplantation. All patients with CMV DNAemia received pre-emptive ganciclovir until two consecutive negative results were obtained. CMV-IgG-positive patients (R+) had a significantly increased risk of DNAemia as compared to CMV-IgG-negative (R-) patients (62% vs 8%) P<0.0001. The incidence of DNAemia was 71% (10/14) in R+ transplanted from seronegative donors (D-) compared to 54% (13/32) in those transplanted from seropositive donors (D+). Of 30 (40%) children with DNAemia, 12 developed CMV disease despite pre-emptive treatment. The overall incidence of disease was 0% (0/59) for R-/D-, 9% (3/23) for R+/D+, 7% (2/29) for R-/D+ and 57% (8/14) for R+/D-. In patients with DNAemia, 4/20 (20%) patients with D+ and 8/10 (80%) with D- became symptomatic. In the multivariate analysis of both groups, patients at risk (R+ and/or D+) and patients with DNAemia, a negative donor serostatus was the only factor associated with a significantly increased incidence of disease. Seven of 9 patients with lethal CMV disease had received CMV-IgG-negative grafts. The data suggest that in CMV seropositive recipients donor CMV seropositivity is associated with a reduced incidence of CMV disease and a favourable outcome following pre-emptive treatment. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/12732888/Pre_emptive_treatment_of_CMV_DNAemia_in_paediatric_stem_cell_transplantation:_the_impact_of_recipient_and_donor_CMV_serostatus_on_the_incidence_of_CMV_disease_and_CMV_related_mortality_ L2 - https://doi.org/10.1038/sj.bmt.1703927 DB - PRIME DP - Unbound Medicine ER -