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Cytomegalovirus antigenemia and outcomes of patients undergoing allogeneic peripheral blood stem cell transplantation: effects of long-term high-dose acyclovir prophylaxis and preemptive ganciclovir treatment.
Jpn J Infect Dis. 2006 Aug; 59(4):216-21.JJ

Abstract

Cytomegalovirus (CMV) disease is a frequent cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. In order to investigate the relationships between antigenemia, high-dose acyclovir (HDACV) prophylaxis, preemptive ganciclovir (GCV) therapy, and outcomes, we analyzed the records of 105 patients, including both pediatric and adult populations, who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) and who were at risk for CMV reactivation and disease (both recipient and donor seropositive). All received HDACV until neutrophil engraftment, but prophylaxis was continued till post-transplant day 180 only in pediatric patients in conjunction with weekly CMV pp65 antigenemia monitoring. Antigenemia-guided preemptive strategy with GCV was used for all patients. CMV antigenemia developed in 45 patients (42.9%) and CMV disease in 13 (12.4%). The frequencies for antigenemia were 31.3 and 63.2% in pediatric and adult groups (P = 0.002). All CMV diseases were in the adult group (P<0.001). Age at transplantation, underlying disease, long-term HDACV prophylaxis and acute graft versus host disease (aGVHD) were all found to be a significant risk factors for antigenemia. All of these factors other than aGVHD and conditioning regimen were also the significant risk factors for CMV disease. However, when we analyzed the pediatric and adult patients separately, dropping "long-term HDACV prophylaxis," none of these parameters were significant risk factors for CMV disease. In conclusion, we hypothesize that long-term HDACV prophylaxis in the GCV era results in a low incidence of CMV reactivation and disease in patients undergoing PBSCT.

Authors+Show Affiliations

Department of Pediatric Hematology and Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey. hazar@akdeniz.edu.trNo 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16936338

Citation

Hazar, Volkan, et al. "Cytomegalovirus Antigenemia and Outcomes of Patients Undergoing Allogeneic Peripheral Blood Stem Cell Transplantation: Effects of Long-term High-dose Acyclovir Prophylaxis and Preemptive Ganciclovir Treatment." Japanese Journal of Infectious Diseases, vol. 59, no. 4, 2006, pp. 216-21.
Hazar V, Ugur A, Colak D, et al. Cytomegalovirus antigenemia and outcomes of patients undergoing allogeneic peripheral blood stem cell transplantation: effects of long-term high-dose acyclovir prophylaxis and preemptive ganciclovir treatment. Jpn J Infect Dis. 2006;59(4):216-21.
Hazar, V., Ugur, A., Colak, D., Saba, R., Tezcan, G., Kupesiz, A., Karadogan, I., Gultekin, M., Yesilipek, A., & Undar, L. (2006). Cytomegalovirus antigenemia and outcomes of patients undergoing allogeneic peripheral blood stem cell transplantation: effects of long-term high-dose acyclovir prophylaxis and preemptive ganciclovir treatment. Japanese Journal of Infectious Diseases, 59(4), 216-21.
Hazar V, et al. Cytomegalovirus Antigenemia and Outcomes of Patients Undergoing Allogeneic Peripheral Blood Stem Cell Transplantation: Effects of Long-term High-dose Acyclovir Prophylaxis and Preemptive Ganciclovir Treatment. Jpn J Infect Dis. 2006;59(4):216-21. PubMed PMID: 16936338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus antigenemia and outcomes of patients undergoing allogeneic peripheral blood stem cell transplantation: effects of long-term high-dose acyclovir prophylaxis and preemptive ganciclovir treatment. AU - Hazar,Volkan, AU - Ugur,Aynur, AU - Colak,Dilek, AU - Saba,Rabin, AU - Tezcan,Gulsun, AU - Kupesiz,Alphan, AU - Karadogan,Ihsan, AU - Gultekin,Meral, AU - Yesilipek,Akif, AU - Undar,Levent, PY - 2006/8/29/pubmed PY - 2006/10/13/medline PY - 2006/8/29/entrez SP - 216 EP - 21 JF - Japanese journal of infectious diseases JO - Jpn J Infect Dis VL - 59 IS - 4 N2 - Cytomegalovirus (CMV) disease is a frequent cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. In order to investigate the relationships between antigenemia, high-dose acyclovir (HDACV) prophylaxis, preemptive ganciclovir (GCV) therapy, and outcomes, we analyzed the records of 105 patients, including both pediatric and adult populations, who underwent allogeneic peripheral blood stem cell transplantation (PBSCT) and who were at risk for CMV reactivation and disease (both recipient and donor seropositive). All received HDACV until neutrophil engraftment, but prophylaxis was continued till post-transplant day 180 only in pediatric patients in conjunction with weekly CMV pp65 antigenemia monitoring. Antigenemia-guided preemptive strategy with GCV was used for all patients. CMV antigenemia developed in 45 patients (42.9%) and CMV disease in 13 (12.4%). The frequencies for antigenemia were 31.3 and 63.2% in pediatric and adult groups (P = 0.002). All CMV diseases were in the adult group (P<0.001). Age at transplantation, underlying disease, long-term HDACV prophylaxis and acute graft versus host disease (aGVHD) were all found to be a significant risk factors for antigenemia. All of these factors other than aGVHD and conditioning regimen were also the significant risk factors for CMV disease. However, when we analyzed the pediatric and adult patients separately, dropping "long-term HDACV prophylaxis," none of these parameters were significant risk factors for CMV disease. In conclusion, we hypothesize that long-term HDACV prophylaxis in the GCV era results in a low incidence of CMV reactivation and disease in patients undergoing PBSCT. SN - 1344-6304 UR - https://www.unboundmedicine.com/medline/citation/16936338/Cytomegalovirus_antigenemia_and_outcomes_of_patients_undergoing_allogeneic_peripheral_blood_stem_cell_transplantation:_effects_of_long_term_high_dose_acyclovir_prophylaxis_and_preemptive_ganciclovir_treatment_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -