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Use of the cytomegalovirus pp65 antigenemia assay for preemptive therapy in allogeneic hematopoietic stem cell transplantation: a real-world review.
Transpl Infect Dis. 2008 Oct; 10(5):325-32.TI

Abstract

Despite advances in surveillance strategies and antivirals, cytomegalovirus (CMV) infection continues to pose problems to patients receiving hematopoietic stem cell transplants (HSCTs). The bone marrow transplant (BMT) unit at the Singapore General Hospital embraced the preemptive strategy in late 2003. Although several studies have demonstrated its usefulness, we conducted this review to document CMV-related events at our institution. Forty-six patients underwent CMV surveillance using the CMV pp65 antigenemia (CMV Ag) assay from January 2004 to December 2005. Twenty-seven patients had CMV infection, and 19 remained antigenemia-negative. No differences were found between the 2 groups for the following potential risk factors for CMV infection: age, total number of co-morbidities, duration of neutropenia after conditioning, baseline creatinine, type of conditioning regimen (conventional vs. reduced intensity), type of transplant (matched sibling vs. others), recipient CMV status, donor CMV status, and use of total body irradiation. Two patients received alemtuzumab; both developed CMV Ag. Twelve episodes of CMV infection occurred after the 100th post-HSCT day. Two patients developed CMV disease. One of them could be considered a failure of the preemptive strategy, as she had CMV gastritis diagnosed on the same day that she became pp65-positive. The other developed CMV disease despite prompt institution of ganciclovir, although she had multiple post-HSCT complications requiring enhanced immunosuppression, as well as relapsed disease. One-year disease-free survival was 55.5% in those with CMV infection and 52.3% in those without infection. Survival was not affected by CMV infection.

Authors+Show Affiliations

Infectious Diseases Unit, Department of Internal Medicine, Singapore General Hospital, Singapore. Tan.ban.hock@sgh.com.sgNo 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

18627578

Citation

Tan, B H., et al. "Use of the Cytomegalovirus Pp65 Antigenemia Assay for Preemptive Therapy in Allogeneic Hematopoietic Stem Cell Transplantation: a Real-world Review." Transplant Infectious Disease : an Official Journal of the Transplantation Society, vol. 10, no. 5, 2008, pp. 325-32.
Tan BH, Chlebicka NL, Low JG, et al. Use of the cytomegalovirus pp65 antigenemia assay for preemptive therapy in allogeneic hematopoietic stem cell transplantation: a real-world review. Transpl Infect Dis. 2008;10(5):325-32.
Tan, B. H., Chlebicka, N. L., Low, J. G., Chong, T. Y., Chan, K. P., & Goh, Y. T. (2008). Use of the cytomegalovirus pp65 antigenemia assay for preemptive therapy in allogeneic hematopoietic stem cell transplantation: a real-world review. Transplant Infectious Disease : an Official Journal of the Transplantation Society, 10(5), 325-32. https://doi.org/10.1111/j.1399-3062.2008.00325.x
Tan BH, et al. Use of the Cytomegalovirus Pp65 Antigenemia Assay for Preemptive Therapy in Allogeneic Hematopoietic Stem Cell Transplantation: a Real-world Review. Transpl Infect Dis. 2008;10(5):325-32. PubMed PMID: 18627578.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of the cytomegalovirus pp65 antigenemia assay for preemptive therapy in allogeneic hematopoietic stem cell transplantation: a real-world review. AU - Tan,B H, AU - Chlebicka,N L, AU - Low,J G Hong, AU - Chong,T Y R, AU - Chan,K P, AU - Goh,Y T, Y1 - 2008/07/08/ PY - 2008/7/17/pubmed PY - 2008/12/17/medline PY - 2008/7/17/entrez SP - 325 EP - 32 JF - Transplant infectious disease : an official journal of the Transplantation Society JO - Transpl Infect Dis VL - 10 IS - 5 N2 - Despite advances in surveillance strategies and antivirals, cytomegalovirus (CMV) infection continues to pose problems to patients receiving hematopoietic stem cell transplants (HSCTs). The bone marrow transplant (BMT) unit at the Singapore General Hospital embraced the preemptive strategy in late 2003. Although several studies have demonstrated its usefulness, we conducted this review to document CMV-related events at our institution. Forty-six patients underwent CMV surveillance using the CMV pp65 antigenemia (CMV Ag) assay from January 2004 to December 2005. Twenty-seven patients had CMV infection, and 19 remained antigenemia-negative. No differences were found between the 2 groups for the following potential risk factors for CMV infection: age, total number of co-morbidities, duration of neutropenia after conditioning, baseline creatinine, type of conditioning regimen (conventional vs. reduced intensity), type of transplant (matched sibling vs. others), recipient CMV status, donor CMV status, and use of total body irradiation. Two patients received alemtuzumab; both developed CMV Ag. Twelve episodes of CMV infection occurred after the 100th post-HSCT day. Two patients developed CMV disease. One of them could be considered a failure of the preemptive strategy, as she had CMV gastritis diagnosed on the same day that she became pp65-positive. The other developed CMV disease despite prompt institution of ganciclovir, although she had multiple post-HSCT complications requiring enhanced immunosuppression, as well as relapsed disease. One-year disease-free survival was 55.5% in those with CMV infection and 52.3% in those without infection. Survival was not affected by CMV infection. SN - 1399-3062 UR - https://www.unboundmedicine.com/medline/citation/18627578/Use_of_the_cytomegalovirus_pp65_antigenemia_assay_for_preemptive_therapy_in_allogeneic_hematopoietic_stem_cell_transplantation:_a_real_world_review_ L2 - https://doi.org/10.1111/j.1399-3062.2008.00325.x DB - PRIME DP - Unbound Medicine ER -