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Regimen-related mucosal injury of the gut increased the incidence of CMV disease after allogeneic bone marrow transplantation.
Biol Blood Marrow Transplant. 2009 Jun; 15(6):679-85.BB

Abstract

Cytomegalovirus (CMV) infection is 1 of the major causes of morbidity in patients undergoing allogeneic stem cell transplantation (allo-SCT). The incidences of CMV antigenemia and CMV disease in 43 patients who received allogeneic bone marrow transplantation (BMT) using a reduced-intensity conditioning (RIC) regimen, which mainly consisted of fludarabine (Flu), busulfan (Bu), and total body irradiation (TBI), were compared with those in 68 patients who received a myeloablative conditioning (MAC) regimen, and risk factors for CMV antigenemia and CMV disease were identified. Before engraftment, grade 3-4 mucosal injury because of the conditioning regimen was significantly decreased in RIC patients (stomatitis: P = .02; diarrhea: P < .01). Rate of engraftment, incidences of acute graft-versus-host disease (aGVHD), and rate of corticosteroid administration were not different in RIC patients and MAC patients. Although the incidences of CMV antigenemia were not significantly different in RIC patients and MAC patients (64.1% versus 57.8%, log rank, P = .59), the incidence of CMV disease was significantly decreased in RIC patients (5.4% versus 20.3%, log rank, P = .04). CMV seropositivity in the patients (P < .01) and corticosteroid administration (P < .01) were revealed by multivariate analysis to be significant risk factors for CMV antigenemia. Grade II-IV aGVHD (P = .02) and grade 3-4 diarrhea before engraftment (P = .04) were revealed to be risk factors for CMV disease. The present study is the first study to show that severe diarrhea before engraftment is a significant risk factor for CMV disease. In summary, risk of CMV disease was significantly decreased in patients without severe mucosal injury of the gut because of the conditioning regimen before engraftment.

Authors+Show Affiliations

Stem Cell Transplantation Center, Hokkaido University Hospital, Sapporo, Japan. shigema@med.hokudai.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 available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19450752

Citation

Shigematsu, Akio, et al. "Regimen-related Mucosal Injury of the Gut Increased the Incidence of CMV Disease After Allogeneic Bone Marrow Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 15, no. 6, 2009, pp. 679-85.
Shigematsu A, Yasumoto A, Yamamoto S, et al. Regimen-related mucosal injury of the gut increased the incidence of CMV disease after allogeneic bone marrow transplantation. Biol Blood Marrow Transplant. 2009;15(6):679-85.
Shigematsu, A., Yasumoto, A., Yamamoto, S., Sugita, J., Kondo, T., Onozawa, M., Kahata, K., Endo, T., Ota, S., Sato, N., Takahata, M., Okada, K., Tanaka, J., Hashino, S., Nishio, M., Koike, T., Asaka, M., & Imamura, M. (2009). Regimen-related mucosal injury of the gut increased the incidence of CMV disease after allogeneic bone marrow transplantation. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 15(6), 679-85. https://doi.org/10.1016/j.bbmt.2009.02.006
Shigematsu A, et al. Regimen-related Mucosal Injury of the Gut Increased the Incidence of CMV Disease After Allogeneic Bone Marrow Transplantation. Biol Blood Marrow Transplant. 2009;15(6):679-85. PubMed PMID: 19450752.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regimen-related mucosal injury of the gut increased the incidence of CMV disease after allogeneic bone marrow transplantation. AU - Shigematsu,Akio, AU - Yasumoto,Atsushi, AU - Yamamoto,Satoshi, AU - Sugita,Junichi, AU - Kondo,Takeshi, AU - Onozawa,Masahiro, AU - Kahata,Kaoru, AU - Endo,Tomoyuki, AU - Ota,Shuichi, AU - Sato,Norihiro, AU - Takahata,Mutsumi, AU - Okada,Kohei, AU - Tanaka,Junji, AU - Hashino,Satoshi, AU - Nishio,Mitsufumi, AU - Koike,Takao, AU - Asaka,Masahiro, AU - Imamura,Masahiro, Y1 - 2009/04/11/ PY - 2008/10/21/received PY - 2009/02/20/accepted PY - 2009/5/20/entrez PY - 2009/5/20/pubmed PY - 2009/9/29/medline SP - 679 EP - 85 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 15 IS - 6 N2 - Cytomegalovirus (CMV) infection is 1 of the major causes of morbidity in patients undergoing allogeneic stem cell transplantation (allo-SCT). The incidences of CMV antigenemia and CMV disease in 43 patients who received allogeneic bone marrow transplantation (BMT) using a reduced-intensity conditioning (RIC) regimen, which mainly consisted of fludarabine (Flu), busulfan (Bu), and total body irradiation (TBI), were compared with those in 68 patients who received a myeloablative conditioning (MAC) regimen, and risk factors for CMV antigenemia and CMV disease were identified. Before engraftment, grade 3-4 mucosal injury because of the conditioning regimen was significantly decreased in RIC patients (stomatitis: P = .02; diarrhea: P < .01). Rate of engraftment, incidences of acute graft-versus-host disease (aGVHD), and rate of corticosteroid administration were not different in RIC patients and MAC patients. Although the incidences of CMV antigenemia were not significantly different in RIC patients and MAC patients (64.1% versus 57.8%, log rank, P = .59), the incidence of CMV disease was significantly decreased in RIC patients (5.4% versus 20.3%, log rank, P = .04). CMV seropositivity in the patients (P < .01) and corticosteroid administration (P < .01) were revealed by multivariate analysis to be significant risk factors for CMV antigenemia. Grade II-IV aGVHD (P = .02) and grade 3-4 diarrhea before engraftment (P = .04) were revealed to be risk factors for CMV disease. The present study is the first study to show that severe diarrhea before engraftment is a significant risk factor for CMV disease. In summary, risk of CMV disease was significantly decreased in patients without severe mucosal injury of the gut because of the conditioning regimen before engraftment. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/19450752/Regimen_related_mucosal_injury_of_the_gut_increased_the_incidence_of_CMV_disease_after_allogeneic_bone_marrow_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(09)00110-4 DB - PRIME DP - Unbound Medicine ER -