[HTML][HTML] Cytomegalovirus infections following umbilical cord blood transplantation using reduced intensity conditioning regimens for adult patients

T Matsumura, H Narimatsu, M Kami, K Yuji… - Biology of Blood and …, 2007 - Elsevier
T Matsumura, H Narimatsu, M Kami, K Yuji, E Kusumi, A Hori, N Murashige, Y Tanaka…
Biology of Blood and Marrow Transplantation, 2007Elsevier
Cytomegalovirus (CMV) infection is a major complication after allogeneic hematopoietic
stem cell transplantation (Allo-HSCT); however, we have little information on the clinical
features of CMV reactivation after cord blood transplantation using reduced-intensity
regimens (RI-CBT) for adults. We reviewed medical records of 140 patients who underwent
RI-CBT at Toranomon Hospital between January 2002 and March 2005. All the patients
were monitored for CMV-antigenemia weekly, and, if turned positive, received preemptive …
Cytomegalovirus (CMV) infection is a major complication after allogeneic hematopoietic stem cell transplantation (Allo-HSCT); however, we have little information on the clinical features of CMV reactivation after cord blood transplantation using reduced-intensity regimens (RI-CBT) for adults. We reviewed medical records of 140 patients who underwent RI-CBT at Toranomon Hospital between January 2002 and March 2005. All the patients were monitored for CMV-antigenemia weekly, and, if turned positive, received preemptive foscarnet or ganciclovir. Seventy-seven patients developed positive antigenemia at a median onset of day 35 (range, 4-92) after transplant. Median of the maximal number of CMV pp65-positive cells per 50,000 cells was 22 (range, 1-1806). CMV disease developed in 22 patients on a median of day 35 (range, 15-106); 21 had enterocolitis and 1 had adrenalitis. CMV antigenemia had not been detected in 2 patients, when CMV disease was diagnosed. CMV disease was successfully treated using ganciclovir or foscarnet in 14 patients. The other 8 patients died without improvement of CMV disease. In multivariate analysis, grade II-IV acute graft-versus-host disease was a risk factor of CMV disease (relative risk 3.48, 95% confidential interval 1.47-8.23). CMV reactivation and disease develop early after RI-CBT. CMV enterocolitis may be a common complication after RI-CBT.
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