Risk of cytomegalovirus infection after peripheral blood stem cell transplantation

Abstract

Summary:on day 35. When patients whose specimens tested positive for CMV by shell vial culture were treated with ganciclovir prophylactically, it prevented the development of CMV-IP From 1992 to 1995, 105 patients received PBSCT in our hospitals and we observed no incidence of CMV-pneufrom asymptomatic CMV infection. There are, however, few reports of the development to clinical CMV infection in monia. To clarify whether activation of CMV occurs in these patients, shell vial cultures, CMV antigenemia and patients receiving peripheral blood stem cell transplantation (PBSCT). From 1992 to 1995, 105 patients with leukemia, lymphoma every 1 to 2 weeks after transplantation to determine or solid tumors of advanced stage received PBSCT in our whether and when CMV was activated. Two patients hospitals. Seventeen patients were monitored for CMV actitested positive transiently by DNA-PCR but negative vation by three viral detection methods on day 35, and six throughout by both antigenemia and RT-PCR. These patients were monitored every 1 to 2 weeks. Details of 17 results suggest that the risk of CMV infection is low patients are given in Table 1. For prophylaxis of CMV because the incidence of CMV activation in patients infection, all patients received irradiated blood products receiving PBSCT is low.which were depleted of leukocytes by filters. They were Keywords: CMV; interstitial pneumonia; PBSCT; antialso treated with acyclovir at a dose of 15 mg/kg/day for genemia assay; shell vial culture method; RT-PCR method 30 days and anti-CMV antibody hyperimmune globulin at a dose of 200 mg/kg once a week for 3 months, and once every 2 weeks for the next 3 months after transplantation. 5CMV interstitial pneumonia (IP) is a significant complication after allogenic BMT (alloBMT). The incidence of Samples CMV-IP was about 20% and the mortality rate about 80% over a 10-year period.1-3 Prevention and treatment of Bronchoalveolar lavage (BAL) samples, peripheral blood CMV-IP is an important factor in improving the prognosis leukocyte (polymorphonuclear cells (PMNC) and monoof alloBMT patients. Recently, combined therapy with gannuclear cells (MNC)) samples and urine samples were ciclovir and anti-CMV hyperimmune globulin in the early taken from the patients on day 35 after transplantation. In stages of CMV-IP has been shown to improve survival, and addition, six of the patients were evaluated for the presence the mortality rate of such patients could be reduced to 10-of CMV antigen and DNA in PBLC using antigenemia and 20%. [4][5][6][7] To further reduce the mortality rate, it is necessary PCR methods every 1 to 2 weeks after transplantation. The to prevent the development to CMV-IP from asymptomatic BAL fluid was centrifuged and divided into supernatant CMV infection. 5,6 Schmidt et al 8 evaluated 104 patients (BALF) and pellet-containing BAL cells (BALC). BALF who had received alloBMT and from whom BAL was taken and BALC were prepared for CMV testing with shell vial culture and PCR methods. 5 × 10 4 cells obtained from cytospins ...

Cytomegalovirus viremia, viruria and disease after autologous peripheral blood stem cell transplantation: no need for surveillance

“…[11][12][13][14][15][16][17][18] Recently, PCR detection of CMV-DNA has also been utilized in such surveillance programs. Viral culture and antigen detection are positive in 7-45% of patients following autologous transplantation.…”

“…11 Very few studies of CMV viremia, viruria, DNAemia and disease have been reported following autologous peripheral blood stem cell transplantation (PBSCT). [12][13][14][15][16] We evaluated 200 consecutive recipients of autologous PBSCT in order to ascertain the incidence, risk factors, clinical manifestations, complications and outcome of CMV viremia, viruria, DNAemia and disease. All previously reported studies of CMV viremia and disease in such patients have been based on a variety of surveillance programs.…”

“…All previously reported studies of CMV viremia and disease in such patients have been based on a variety of surveillance programs. [11][12][13][14][15][16][17][18] Some investigators believe that surveillance is unnecessary in patients undergoing autologous transplantation because of a low likelihood of complications. 14 Moreover, surveillance studies can be expensive and timeconsuming.…”

Peripheral blood stem cell autografts for the treatment of children over 1 year old with stage IV neuroblastoma: a long-term follow-up

“…Hematological recovery was evaluated in 21 patients, excluding one very early death. The median number of days to achieve an absolute granulocyte count of Ͼ0.5 ϫ 10 9 /l and a WBC count of Ͼ1.0 ϫ 10 9 /l was, respectively, 11 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) and 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The median time required for platelets to rise above 50 ϫ 10 9 /l was 46 days (11-168 days).…”

“…Since 1987, we have been testing the clinical value of a PBSCT program for children with various malignant diseases. 18 We have suggested that the procedure can be used relatively safely in pediatric cancer patients, 19,20 and at least some groups of children, ie those with relapsed acute lymphoblastic leukemia (ALL), may benefit from high-dose therapy and PBSCT. 15 Considering the poor prognosis of patients with NB treated by currently available therapeutic modalities, the rapid recovery of hematopoiesis after PBSCT may make this procedure suitable for wider use as a first-line therapy for NB.…”