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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.
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
html.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.


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