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Fludarabine-based reduced intensity conditioning transplants have a higher incidence of cytomegalovirus reactivation compared with myeloablative transplants.
Bone Marrow Transplant. 2010 May; 45(5):849-55.BM

Abstract

Two hundred and ten adult CMV seropositive patients undergoing myeloablative conditioning (MAC) [n=127] or reduced intensity conditioning (RIC) [n=83] transplants (HCT) were serially monitored for CMV reactivation and disease, using a qualitative polymerase chain reaction (PCR) followed by quantitation with pp65 antigen or quantitative PCR. CMV reactivation occurred in 53 RIC (63.9%) and 61 MAC (48%; P=0.03) transplants at a median of 47 days (range: 24-1977). Risk factors identified included acute GVHD (P=0.001), RIC regimen (P=0.03), unrelated donor (P=0.02), use of anti-thymocyte globulin/alemtuzumb (P=0.02) and use of bone marrow in MAC transplants (P=0.011). On multivariate analysis, RIC transplants and acute GVHD remained independent predictors. Treatment with antiviral drugs resulted in CMV negativity rates of 86.8% in MAC and 88.6% in RIC transplants. CMV disease occurred in 10.8% of RIC and 4.7% of MAC transplants (P=0.15). At a median follow-up of 26 months (range: 3-88), 48.1% of RIC and 50.3% of MAC transplants are alive. The higher incidence of CMV reactivation among RIC transplants suggests the need for novel prophylactic or pre-emptive strategies in this high-risk group of patients.

Authors+Show Affiliations

Department of Haematology, Level II ICPMR, Westmead Hospital, Sydney, New South Wales, Australia. Biju.George@swahs.health.nsw.gov.auNo affiliation info availableNo 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

19915635

Citation

George, B, et al. "Fludarabine-based Reduced Intensity Conditioning Transplants Have a Higher Incidence of Cytomegalovirus Reactivation Compared With Myeloablative Transplants." Bone Marrow Transplantation, vol. 45, no. 5, 2010, pp. 849-55.
George B, Kerridge I, Gilroy N, et al. Fludarabine-based reduced intensity conditioning transplants have a higher incidence of cytomegalovirus reactivation compared with myeloablative transplants. Bone Marrow Transplant. 2010;45(5):849-55.
George, B., Kerridge, I., Gilroy, N., Huang, G., Hertzberg, M., Gottlieb, D., & Bradstock, K. (2010). Fludarabine-based reduced intensity conditioning transplants have a higher incidence of cytomegalovirus reactivation compared with myeloablative transplants. Bone Marrow Transplantation, 45(5), 849-55. https://doi.org/10.1038/bmt.2009.273
George B, et al. Fludarabine-based Reduced Intensity Conditioning Transplants Have a Higher Incidence of Cytomegalovirus Reactivation Compared With Myeloablative Transplants. Bone Marrow Transplant. 2010;45(5):849-55. PubMed PMID: 19915635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fludarabine-based reduced intensity conditioning transplants have a higher incidence of cytomegalovirus reactivation compared with myeloablative transplants. AU - George,B, AU - Kerridge,I, AU - Gilroy,N, AU - Huang,G, AU - Hertzberg,M, AU - Gottlieb,D, AU - Bradstock,K, Y1 - 2009/11/16/ PY - 2009/11/17/entrez PY - 2009/11/17/pubmed PY - 2010/12/17/medline SP - 849 EP - 55 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 45 IS - 5 N2 - Two hundred and ten adult CMV seropositive patients undergoing myeloablative conditioning (MAC) [n=127] or reduced intensity conditioning (RIC) [n=83] transplants (HCT) were serially monitored for CMV reactivation and disease, using a qualitative polymerase chain reaction (PCR) followed by quantitation with pp65 antigen or quantitative PCR. CMV reactivation occurred in 53 RIC (63.9%) and 61 MAC (48%; P=0.03) transplants at a median of 47 days (range: 24-1977). Risk factors identified included acute GVHD (P=0.001), RIC regimen (P=0.03), unrelated donor (P=0.02), use of anti-thymocyte globulin/alemtuzumb (P=0.02) and use of bone marrow in MAC transplants (P=0.011). On multivariate analysis, RIC transplants and acute GVHD remained independent predictors. Treatment with antiviral drugs resulted in CMV negativity rates of 86.8% in MAC and 88.6% in RIC transplants. CMV disease occurred in 10.8% of RIC and 4.7% of MAC transplants (P=0.15). At a median follow-up of 26 months (range: 3-88), 48.1% of RIC and 50.3% of MAC transplants are alive. The higher incidence of CMV reactivation among RIC transplants suggests the need for novel prophylactic or pre-emptive strategies in this high-risk group of patients. SN - 1476-5365 UR - https://www.unboundmedicine.com/medline/citation/19915635/Fludarabine_based_reduced_intensity_conditioning_transplants_have_a_higher_incidence_of_cytomegalovirus_reactivation_compared_with_myeloablative_transplants_ L2 - https://doi.org/10.1038/bmt.2009.273 DB - PRIME DP - Unbound Medicine ER -