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CMV-antigenemia after allogeneic bone marrow transplantation: correlation of CMV-antigen positive cell numbers with transplant-related mortality.
Bone Marrow Transplant. 1995 Jul; 16(1):155-61.BM

Abstract

One hundred and thirty-four consecutive patients undergoing HLA-identical BMT were prospectively followed on a weekly basis for the development of CMV antigenemia (CMVAg-emia). End-points of the study were (1) incidence, (2) risk factors, and (3) predictive effect on transplant-related mortality (TRM). Fifty-six patients developed CMVAg-emia between day 8-366 (median 40) with an overall actuarial risk of 43%. The median number of positive cells a diagnosis was 4 (range 1-48) the median maximum number was 6.5 (range 1-435). Positive cells are expressed as number/2.5 x 10(5) cells. In multivariate analysis, T cell depletion (TCD) (RR 2.9, P = 0.0009) and acute graft-versus-host disease (RR 2.1, P = 0.01) were the two risk factors predictive for CMVAg-emia. The risk of developing CMV-IP was significantly higher in patients with, as compared to patients without, CMVAg-emia (P = 0.0005) and occurred mostly in patients who received TCD marrow (P = 0.0009) despite treatment with gancyclovir or foscarnet at the time of CMVAg-emia. TRM was 24% in patients not developing CMVAg-emia; it was 21 and 47% in patients with "4" positive cells at diagnosis of CMV (P = 0.008), and 12 vs 54% for patients with "6" positive cells during infection (P = 0.0003). Both were predictive of TRM in multivariate analysis (P = 0.04 and P = 0.002). In conclusion, the risk of developing CMVAg-emia post-allo BMT is influenced by the marrow T cell content and by the occurrence of acute GVHD. High numbers of CMV antigen positive cells are associated with considerable transplant-related mortality, and may therefore identify patients eligible for early aggressive therapy.

Authors+Show Affiliations

Divisione Ematologia II, Ospedale San Martino, Genova, Italy.No 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

7581116

Citation

Bacigalupo, A, et al. "CMV-antigenemia After Allogeneic Bone Marrow Transplantation: Correlation of CMV-antigen Positive Cell Numbers With Transplant-related Mortality." Bone Marrow Transplantation, vol. 16, no. 1, 1995, pp. 155-61.
Bacigalupo A, Tedone E, Isaza A, et al. CMV-antigenemia after allogeneic bone marrow transplantation: correlation of CMV-antigen positive cell numbers with transplant-related mortality. Bone Marrow Transplant. 1995;16(1):155-61.
Bacigalupo, A., Tedone, E., Isaza, A., Soracco, M., Van Lint, M. T., Sanna, A., Frassoni, F., Occhini, D., Gualandi, F., & Lamparelli, T. (1995). CMV-antigenemia after allogeneic bone marrow transplantation: correlation of CMV-antigen positive cell numbers with transplant-related mortality. Bone Marrow Transplantation, 16(1), 155-61.
Bacigalupo A, et al. CMV-antigenemia After Allogeneic Bone Marrow Transplantation: Correlation of CMV-antigen Positive Cell Numbers With Transplant-related Mortality. Bone Marrow Transplant. 1995;16(1):155-61. PubMed PMID: 7581116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CMV-antigenemia after allogeneic bone marrow transplantation: correlation of CMV-antigen positive cell numbers with transplant-related mortality. A1 - Bacigalupo,A, AU - Tedone,E, AU - Isaza,A, AU - Soracco,M, AU - Van Lint,M T, AU - Sanna,A, AU - Frassoni,F, AU - Occhini,D, AU - Gualandi,F, AU - Lamparelli,T, PY - 1995/7/1/pubmed PY - 1995/7/1/medline PY - 1995/7/1/entrez SP - 155 EP - 61 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 16 IS - 1 N2 - One hundred and thirty-four consecutive patients undergoing HLA-identical BMT were prospectively followed on a weekly basis for the development of CMV antigenemia (CMVAg-emia). End-points of the study were (1) incidence, (2) risk factors, and (3) predictive effect on transplant-related mortality (TRM). Fifty-six patients developed CMVAg-emia between day 8-366 (median 40) with an overall actuarial risk of 43%. The median number of positive cells a diagnosis was 4 (range 1-48) the median maximum number was 6.5 (range 1-435). Positive cells are expressed as number/2.5 x 10(5) cells. In multivariate analysis, T cell depletion (TCD) (RR 2.9, P = 0.0009) and acute graft-versus-host disease (RR 2.1, P = 0.01) were the two risk factors predictive for CMVAg-emia. The risk of developing CMV-IP was significantly higher in patients with, as compared to patients without, CMVAg-emia (P = 0.0005) and occurred mostly in patients who received TCD marrow (P = 0.0009) despite treatment with gancyclovir or foscarnet at the time of CMVAg-emia. TRM was 24% in patients not developing CMVAg-emia; it was 21 and 47% in patients with "4" positive cells at diagnosis of CMV (P = 0.008), and 12 vs 54% for patients with "6" positive cells during infection (P = 0.0003). Both were predictive of TRM in multivariate analysis (P = 0.04 and P = 0.002). In conclusion, the risk of developing CMVAg-emia post-allo BMT is influenced by the marrow T cell content and by the occurrence of acute GVHD. High numbers of CMV antigen positive cells are associated with considerable transplant-related mortality, and may therefore identify patients eligible for early aggressive therapy. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/7581116/CMV_antigenemia_after_allogeneic_bone_marrow_transplantation:_correlation_of_CMV_antigen_positive_cell_numbers_with_transplant_related_mortality_ L2 - http://www.diseaseinfosearch.org/result/7171 DB - PRIME DP - Unbound Medicine ER -