Active CMV disease does not always correlate with viral load detection.
Authors
Ruell, JBarnes, C
Mutton, K J
Foulkes, Barbara
Chang, J
Cavet, James
Guiver, M
Menasce, Lia P
Dougal, Mark
Chopra, Rajesh
Affiliation
Department of Haematology, University of Manchester, Christie Hospital, Manchester, UK. jruell@aol.comIssue Date
2007-07
Metadata
Show full item recordAbstract
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.Citation
Active CMV disease does not always correlate with viral load detection. 2007, 40 (1):55-61 Bone Marrow Transplant.Journal
Bone Marrow TransplantationDOI
10.1038/sj.bmt.1705671PubMed ID
17468776Type
ArticleLanguage
enISSN
0268-3369ae974a485f413a2113503eed53cd6c53
10.1038/sj.bmt.1705671
Scopus Count
Collections
Related articles
- Evaluation of the NucliSens CMV pp67 assay for detection and monitoring of human cytomegalovirus infection after allogeneic stem cell transplantation.
- Authors: Hebart H, Rudolph T, Loeffler J, Middeldorp J, Ljubicic T, Jahn G, Einsele H
- Issue date: 2002 Aug
- Dose-adjusted preemptive therapy for cytomegalovirus disease based on real-time polymerase chain reaction after allogeneic hematopoietic stem cell transplantation.
- Authors: Mori T, Okamoto S, Watanabe R, Yajima T, Iwao Y, Yamazaki R, Nakazato T, Sato N, Iguchi T, Nagayama H, Takayama N, Hibi T, Ikeda Y
- Issue date: 2002 May
- Cytomegalovirus antigenemia and outcomes of patients undergoing allogeneic peripheral blood stem cell transplantation: effects of long-term high-dose acyclovir prophylaxis and preemptive ganciclovir treatment.
- Authors: Hazar V, Ugur A, Colak D, Saba R, Tezcan G, Kupesiz A, Karadogan I, Gultekin M, Yesilipek A, Undar L
- Issue date: 2006 Aug
- Surveillance of cytomegalovirus (CMV) DNAemia in pediatric allogeneic stem cell transplantation: incidence and outcome of CMV infection and disease.
- Authors: Bordon V, Bravo S, Van Renterghem L, de Moerloose B, Benoit Y, Laureys G, Dhooge C
- Issue date: 2008 Feb
- Significance of qualitative PCR detection method for preemptive therapy of cytomegalovirus infection in patients after allogeneic hematopoietic stem cell transplantation -- single-centre experience.
- Authors: Skapova D, Racil Z, Dvorakova D, Minarikova D, Mayer J
- Issue date: 2005