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Cytomegalovirus pp65 antigenemia-guided pre-emptive treatment with ganciclovir after allogeneic stem transplantation: a single-center experience.
Bone Marrow Transplant. 1998 Nov; 22(9):899-904.BM

Abstract

The optimal prophylactic strategy for cytomegalovirus (CMV) disease after allogeneic hematopoietic stem cell transplantation has not yet been established. The aim of this study was to analyze our single-center experience with a uniform protocol of CMV antigenemia-guided pre-emptive treatment with ganciclovir (GCV) after allografting. Fifty-two consecutive adult patients, 48 of them transplanted from HLA-identical matched related donors were included. T cell-depleted marrow or peripheral blood were used in 21 cases. After engraftment, weekly blood samples were tested for CMV pp65 antigenemia and viremia (conventional cultures) until day +100. GCV was started if CMV antigenemia and/or CMV viremia were detected. CMV infection (CMV-I) was found in 19 patients (37%). Seven patients suffered from CMV disease (CMV-D), three colitis and four pneumonias. There was one death directly related to CMV-D and three further cases died from refractory GVHD with CMV-D. Only one patient developed CMV pneumonia without any previous positive antigenemia and/or viremia. Multivariate analysis identified grades II-IV acute GVHD (P = 0.02) and peripheral blood stem cell transplantation (P = 0.03) to be risk factors for developing CMV-I. In conclusion, this monitoring protocol allowed early treatment of CMV-I without progression to CMV-D. Pre-emptive therapy had the additional advantage of avoiding GCV administration in most of our allograft recipients.

Authors+Show Affiliations

Clinical Hematology Division, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

9827819

Citation

Manteiga, R, et al. "Cytomegalovirus Pp65 Antigenemia-guided Pre-emptive Treatment With Ganciclovir After Allogeneic Stem Transplantation: a Single-center Experience." Bone Marrow Transplantation, vol. 22, no. 9, 1998, pp. 899-904.
Manteiga R, Martino R, Sureda A, et al. Cytomegalovirus pp65 antigenemia-guided pre-emptive treatment with ganciclovir after allogeneic stem transplantation: a single-center experience. Bone Marrow Transplant. 1998;22(9):899-904.
Manteiga, R., Martino, R., Sureda, A., Labeaga, R., Brunet, S., Sierra, J., & Rabella, N. (1998). Cytomegalovirus pp65 antigenemia-guided pre-emptive treatment with ganciclovir after allogeneic stem transplantation: a single-center experience. Bone Marrow Transplantation, 22(9), 899-904.
Manteiga R, et al. Cytomegalovirus Pp65 Antigenemia-guided Pre-emptive Treatment With Ganciclovir After Allogeneic Stem Transplantation: a Single-center Experience. Bone Marrow Transplant. 1998;22(9):899-904. PubMed PMID: 9827819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus pp65 antigenemia-guided pre-emptive treatment with ganciclovir after allogeneic stem transplantation: a single-center experience. AU - Manteiga,R, AU - Martino,R, AU - Sureda,A, AU - Labeaga,R, AU - Brunet,S, AU - Sierra,J, AU - Rabella,N, PY - 1998/11/25/pubmed PY - 1998/11/25/medline PY - 1998/11/25/entrez SP - 899 EP - 904 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 22 IS - 9 N2 - The optimal prophylactic strategy for cytomegalovirus (CMV) disease after allogeneic hematopoietic stem cell transplantation has not yet been established. The aim of this study was to analyze our single-center experience with a uniform protocol of CMV antigenemia-guided pre-emptive treatment with ganciclovir (GCV) after allografting. Fifty-two consecutive adult patients, 48 of them transplanted from HLA-identical matched related donors were included. T cell-depleted marrow or peripheral blood were used in 21 cases. After engraftment, weekly blood samples were tested for CMV pp65 antigenemia and viremia (conventional cultures) until day +100. GCV was started if CMV antigenemia and/or CMV viremia were detected. CMV infection (CMV-I) was found in 19 patients (37%). Seven patients suffered from CMV disease (CMV-D), three colitis and four pneumonias. There was one death directly related to CMV-D and three further cases died from refractory GVHD with CMV-D. Only one patient developed CMV pneumonia without any previous positive antigenemia and/or viremia. Multivariate analysis identified grades II-IV acute GVHD (P = 0.02) and peripheral blood stem cell transplantation (P = 0.03) to be risk factors for developing CMV-I. In conclusion, this monitoring protocol allowed early treatment of CMV-I without progression to CMV-D. Pre-emptive therapy had the additional advantage of avoiding GCV administration in most of our allograft recipients. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/9827819/Cytomegalovirus_pp65_antigenemia_guided_pre_emptive_treatment_with_ganciclovir_after_allogeneic_stem_transplantation:_a_single_center_experience_ L2 - https://doi.org/10.1038/sj.bmt.1701439 DB - PRIME DP - Unbound Medicine ER -