Active CMV disease does not always correlate with viral load detection.

2.50
Hdl Handle:
http://hdl.handle.net/10541/71921
Title:
Active CMV disease does not always correlate with viral load detection.
Authors:
Ruell, J; Barnes, C; Mutton, K J; Foulkes, Barbara; Chang, J; Cavet, James; Guiver, M; Menasce, Lia P; Dougal, Mark; Chopra, Rajesh
Abstract:
The use of quantitative cytomegalovirus (CMV) real-time polymerase chain reaction (RT-PCR) and preemptive ganciclovir therapy is replacing prophylaxis as the management of choice in high-risk patients undergoing stem cell transplantation (SCT). However, there are limited data defining its role in this setting. In the current retrospective single-centre study, quantitative RT-PCR was used to determine CMV in 577 consecutive patients undergoing SCT (172 allogeneic and 405 autologous) over a 5-year period. CMV RT-PCR was performed weekly until cessation of immunosuppression (allogeneic) or for 30 days post-SCT (autologous). Treatment was commenced after two consecutive positive results or a high copy on the first occasion (> 1000 copies/ml, > 3 log). The overall CMV reactivation rate in patients undergoing allogeneic SCT was 30%, with reactivation observed in 72% of high-risk patients (recipient positive patients). CMV end-organ disease was observed in eight patients (1%); of these, four were CMV RT-PCR negative at the time of diagnosis of end-organ CMV disease, with three remaining negative throughout the course of the disease. CMV-related mortality was recorded in three patients. The current data support a preemptive treatment strategy-based CMV RT-PCR, but indicate that in symptomatic patients, a negative CMV PCR result does not exclude CMV end-organ disease.
Affiliation:
Department of Haematology, University of Manchester, Christie Hospital, Manchester, UK. jruell@aol.com
Citation:
Active CMV disease does not always correlate with viral load detection. 2007, 40 (1):55-61 Bone Marrow Transplant.
Journal:
Bone Marrow Transplantation
Issue Date:
Jul-2007
URI:
http://hdl.handle.net/10541/71921
DOI:
10.1038/sj.bmt.1705671
PubMed ID:
17468776
Type:
Article
Language:
en
ISSN:
0268-3369
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorRuell, J-
dc.contributor.authorBarnes, C-
dc.contributor.authorMutton, K J-
dc.contributor.authorFoulkes, Barbara-
dc.contributor.authorChang, J-
dc.contributor.authorCavet, James-
dc.contributor.authorGuiver, M-
dc.contributor.authorMenasce, Lia P-
dc.contributor.authorDougal, Mark-
dc.contributor.authorChopra, Rajesh-
dc.date.accessioned2009-06-30T11:33:21Z-
dc.date.available2009-06-30T11:33:21Z-
dc.date.issued2007-07-
dc.identifier.citationActive CMV disease does not always correlate with viral load detection. 2007, 40 (1):55-61 Bone Marrow Transplant.en
dc.identifier.issn0268-3369-
dc.identifier.pmid17468776-
dc.identifier.doi10.1038/sj.bmt.1705671-
dc.identifier.urihttp://hdl.handle.net/10541/71921-
dc.description.abstractThe use of quantitative cytomegalovirus (CMV) real-time polymerase chain reaction (RT-PCR) and preemptive ganciclovir therapy is replacing prophylaxis as the management of choice in high-risk patients undergoing stem cell transplantation (SCT). However, there are limited data defining its role in this setting. In the current retrospective single-centre study, quantitative RT-PCR was used to determine CMV in 577 consecutive patients undergoing SCT (172 allogeneic and 405 autologous) over a 5-year period. CMV RT-PCR was performed weekly until cessation of immunosuppression (allogeneic) or for 30 days post-SCT (autologous). Treatment was commenced after two consecutive positive results or a high copy on the first occasion (> 1000 copies/ml, > 3 log). The overall CMV reactivation rate in patients undergoing allogeneic SCT was 30%, with reactivation observed in 72% of high-risk patients (recipient positive patients). CMV end-organ disease was observed in eight patients (1%); of these, four were CMV RT-PCR negative at the time of diagnosis of end-organ CMV disease, with three remaining negative throughout the course of the disease. CMV-related mortality was recorded in three patients. The current data support a preemptive treatment strategy-based CMV RT-PCR, but indicate that in symptomatic patients, a negative CMV PCR result does not exclude CMV end-organ disease.en
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshCytomegalovirus-
dc.subject.meshCytomegalovirus Infections-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshReproducibility of Results-
dc.subject.meshRetrospective Studies-
dc.subject.meshReverse Transcriptase Polymerase Chain Reaction-
dc.subject.meshStem Cell Transplantation-
dc.subject.meshTransplantation, Autologous-
dc.subject.meshTransplantation, Homologous-
dc.subject.meshViral Load-
dc.titleActive CMV disease does not always correlate with viral load detection.en
dc.typeArticleen
dc.contributor.departmentDepartment of Haematology, University of Manchester, Christie Hospital, Manchester, UK. jruell@aol.comen
dc.identifier.journalBone Marrow Transplantationen

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