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Cytomegalovirus infection in children who underwent hematopoietic stem cell transplantation at a single center: a retrospective study of the risk factors.
Pediatr Transplant. 2009 Nov; 13(7):898-905.PT

Abstract

CMV infection is one of the major causes of morbidity and mortality after HSCT. The aim of this single center retrospective study was to analyze risk factors for CMV infection in pediatric patients who underwent HSCT. We retrospectively reviewed the medical records of 117 pediatric patients who underwent allogeneic HSCT at Asan Medical Center between December 2000 and January 2007. After HSCT, CMV antigenemia was detected by identifying CMV pp65 early antigen in white blood cells. The incidence of CMV antigenemia was 24% (28/117) at a median of 38 days (range: 19-123 days) after HSCT. In multivariate analysis, CMV antigenemia occurred significantly more often in CMV seropositive recipients, patients who received grafts from alternative donors, T-cell depleted grafts, patients on ATG-containing conditioning regimens, or patients who received steroid for acute GVHD (p < 0.05). CMV antigenemia tend to develop earlier in patients who received ATG-containing conditioning regimens (p = 0.09). A second episode of CMV antigenemia was observed in three out of 28 patients (11%). The incidence of CMV disease was 5.9% (7/117) at a median of 97 days (range: 34-120 days). Manifestation of CMV disease included retinitis in two, pneumonitis in two, hepatitis in one, hepatitis with colitis in one, and gastritis in one. Six of the 12 patients (50%) with HG antigenemia (CMV pp65 antigen positivity > or =40 cells) developed clinical CMV disease, a rate that was significantly higher than seen in patients with LG antigenemia (6.25%; p < 0.01). We recommend that patients with these risk factors should carefully undergo regular evaluations for CMV infection. We also suggest that earlier and more aggressive preemptive treatment and serial follow-up of CMV disease is necessary in patients with HG-antigenemia.

Authors+Show Affiliations

Department of Pediatrics, Kyung-Hee University Medical Center, Seoul, Korea.No 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

19032414

Citation

Yoon, Hoi Soo, et al. "Cytomegalovirus Infection in Children Who Underwent Hematopoietic Stem Cell Transplantation at a Single Center: a Retrospective Study of the Risk Factors." Pediatric Transplantation, vol. 13, no. 7, 2009, pp. 898-905.
Yoon HS, Lee JH, Choi ES, et al. Cytomegalovirus infection in children who underwent hematopoietic stem cell transplantation at a single center: a retrospective study of the risk factors. Pediatr Transplant. 2009;13(7):898-905.
Yoon, H. S., Lee, J. H., Choi, E. S., Seo, J. J., Moon, H. N., Kim, M. N., & Im, H. J. (2009). Cytomegalovirus infection in children who underwent hematopoietic stem cell transplantation at a single center: a retrospective study of the risk factors. Pediatric Transplantation, 13(7), 898-905. https://doi.org/10.1111/j.1399-3046.2008.01084.x
Yoon HS, et al. Cytomegalovirus Infection in Children Who Underwent Hematopoietic Stem Cell Transplantation at a Single Center: a Retrospective Study of the Risk Factors. Pediatr Transplant. 2009;13(7):898-905. PubMed PMID: 19032414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus infection in children who underwent hematopoietic stem cell transplantation at a single center: a retrospective study of the risk factors. AU - Yoon,Hoi Soo, AU - Lee,Jae Hee, AU - Choi,Eun Soek, AU - Seo,Jong Jin, AU - Moon,Hyung Nam, AU - Kim,Mi-Na, AU - Im,Ho Joon, Y1 - 2008/11/18/ PY - 2008/11/27/pubmed PY - 2010/1/22/medline PY - 2008/11/27/entrez SP - 898 EP - 905 JF - Pediatric transplantation JO - Pediatr Transplant VL - 13 IS - 7 N2 - CMV infection is one of the major causes of morbidity and mortality after HSCT. The aim of this single center retrospective study was to analyze risk factors for CMV infection in pediatric patients who underwent HSCT. We retrospectively reviewed the medical records of 117 pediatric patients who underwent allogeneic HSCT at Asan Medical Center between December 2000 and January 2007. After HSCT, CMV antigenemia was detected by identifying CMV pp65 early antigen in white blood cells. The incidence of CMV antigenemia was 24% (28/117) at a median of 38 days (range: 19-123 days) after HSCT. In multivariate analysis, CMV antigenemia occurred significantly more often in CMV seropositive recipients, patients who received grafts from alternative donors, T-cell depleted grafts, patients on ATG-containing conditioning regimens, or patients who received steroid for acute GVHD (p < 0.05). CMV antigenemia tend to develop earlier in patients who received ATG-containing conditioning regimens (p = 0.09). A second episode of CMV antigenemia was observed in three out of 28 patients (11%). The incidence of CMV disease was 5.9% (7/117) at a median of 97 days (range: 34-120 days). Manifestation of CMV disease included retinitis in two, pneumonitis in two, hepatitis in one, hepatitis with colitis in one, and gastritis in one. Six of the 12 patients (50%) with HG antigenemia (CMV pp65 antigen positivity > or =40 cells) developed clinical CMV disease, a rate that was significantly higher than seen in patients with LG antigenemia (6.25%; p < 0.01). We recommend that patients with these risk factors should carefully undergo regular evaluations for CMV infection. We also suggest that earlier and more aggressive preemptive treatment and serial follow-up of CMV disease is necessary in patients with HG-antigenemia. SN - 1399-3046 UR - https://www.unboundmedicine.com/medline/citation/19032414/Cytomegalovirus_infection_in_children_who_underwent_hematopoietic_stem_cell_transplantation_at_a_single_center:_a_retrospective_study_of_the_risk_factors_ L2 - https://doi.org/10.1111/j.1399-3046.2008.01084.x DB - PRIME DP - Unbound Medicine ER -