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Cytomegalovirus antigenemia and outcome of patients treated with pre-emptive ganciclovir: retrospective analysis of 241 consecutive patients undergoing allogeneic hematopoietic stem cell transplantation.
Bone Marrow Transplant. 2003 Oct; 32(8):801-7.BM

Abstract

CMV disease remains a major infectious complication after allogeneic hematopoietic stem cell transplantation (HSCT). To investigate the relationship between CMV antigenemia, treatment with ganciclovir (GCV), and outcome, we retrospectively analyzed 241 consecutive patients at risk for CMV infection who underwent allogeneic HSCT. Antigenemia-guided pre-emptive strategy with GCV was used for all patients. CMV antigenemia developed in 169 patients (70.1%), and CMV disease in 18 patients (7.5%). Multivariate analysis showed that acute GVHD (grades II-IV) was the only risk factor for developing antigenemia, and acute GVHD and advanced age for CMV disease. GCV use, as well as acute GVHD and advanced age, significantly increased the risk for bacterial and fungal infection after engraftment. Those who developed CMV antigenemia had a poorer outcome than those who did not (log-rank, P=0.0269), although the development of CMV disease worsened the outcome with only borderline significance (log-rank, P=0.0526). In conclusion, detection of antigenemia proved to be a poor prognostic factor for HSCT patients, which may be attributed to a combination of factors, including CMV disease itself, the effect of treatment, and a host status that allows for reactivation of CMV. Optimal pre-emptive strategy needs to be determined.

Authors+Show Affiliations

Department of Hematology, Nagoya University Graduate School of Medicine, Nagoya, Japan. myanada@med.nagoya-u.ac.jpNo 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 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

14520425

Citation

Yanada, M, et al. "Cytomegalovirus Antigenemia and Outcome of Patients Treated With Pre-emptive Ganciclovir: Retrospective Analysis of 241 Consecutive Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation." Bone Marrow Transplantation, vol. 32, no. 8, 2003, pp. 801-7.
Yanada M, Yamamoto K, Emi N, et al. Cytomegalovirus antigenemia and outcome of patients treated with pre-emptive ganciclovir: retrospective analysis of 241 consecutive patients undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant. 2003;32(8):801-7.
Yanada, M., Yamamoto, K., Emi, N., Naoe, T., Suzuki, R., Taji, H., Iida, H., Shimokawa, T., Kohno, A., Mizuta, S., Maruyama, F., Wakita, A., Kitaori, K., Yano, K., Hamaguchi, M., Hamajima, N., Morishima, Y., Kodera, Y., Sao, H., & Morishita, Y. (2003). Cytomegalovirus antigenemia and outcome of patients treated with pre-emptive ganciclovir: retrospective analysis of 241 consecutive patients undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplantation, 32(8), 801-7.
Yanada M, et al. Cytomegalovirus Antigenemia and Outcome of Patients Treated With Pre-emptive Ganciclovir: Retrospective Analysis of 241 Consecutive Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation. Bone Marrow Transplant. 2003;32(8):801-7. PubMed PMID: 14520425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus antigenemia and outcome of patients treated with pre-emptive ganciclovir: retrospective analysis of 241 consecutive patients undergoing allogeneic hematopoietic stem cell transplantation. AU - Yanada,M, AU - Yamamoto,K, AU - Emi,N, AU - Naoe,T, AU - Suzuki,R, AU - Taji,H, AU - Iida,H, AU - Shimokawa,T, AU - Kohno,A, AU - Mizuta,S, AU - Maruyama,F, AU - Wakita,A, AU - Kitaori,K, AU - Yano,K, AU - Hamaguchi,M, AU - Hamajima,N, AU - Morishima,Y, AU - Kodera,Y, AU - Sao,H, AU - Morishita,Y, PY - 2003/10/2/pubmed PY - 2004/5/28/medline PY - 2003/10/2/entrez SP - 801 EP - 7 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 32 IS - 8 N2 - CMV disease remains a major infectious complication after allogeneic hematopoietic stem cell transplantation (HSCT). To investigate the relationship between CMV antigenemia, treatment with ganciclovir (GCV), and outcome, we retrospectively analyzed 241 consecutive patients at risk for CMV infection who underwent allogeneic HSCT. Antigenemia-guided pre-emptive strategy with GCV was used for all patients. CMV antigenemia developed in 169 patients (70.1%), and CMV disease in 18 patients (7.5%). Multivariate analysis showed that acute GVHD (grades II-IV) was the only risk factor for developing antigenemia, and acute GVHD and advanced age for CMV disease. GCV use, as well as acute GVHD and advanced age, significantly increased the risk for bacterial and fungal infection after engraftment. Those who developed CMV antigenemia had a poorer outcome than those who did not (log-rank, P=0.0269), although the development of CMV disease worsened the outcome with only borderline significance (log-rank, P=0.0526). In conclusion, detection of antigenemia proved to be a poor prognostic factor for HSCT patients, which may be attributed to a combination of factors, including CMV disease itself, the effect of treatment, and a host status that allows for reactivation of CMV. Optimal pre-emptive strategy needs to be determined. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/14520425/Cytomegalovirus_antigenemia_and_outcome_of_patients_treated_with_pre_emptive_ganciclovir:_retrospective_analysis_of_241_consecutive_patients_undergoing_allogeneic_hematopoietic_stem_cell_transplantation_ L2 - https://doi.org/10.1038/sj.bmt.1704232 DB - PRIME DP - Unbound Medicine ER -