Virus reactivation in high-risk non-Hodgkin’s lymphoma patients after autologous CD34+-selected peripheral blood progenitor cell transplantation

Lin, Peng; Lee, Ming Yang; Lin, Jui-Wei; Hsiao, Liang Tsai; Chen, Po Min; Chiou, Tzeon Jye

doi:10.1007/s12185-008-0053-z

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…However, a first group of studies performed in the 1990s showed a not irrelevant figure of CMV reactivation rates, approximately reaching a frequency of 40% in seropositive patients . Subsequently, other reports confirmed the relevance of this issue, although reporting a variable rate of incidence ranging between 30 to 40% and 1 to 13%, according to different diagnostic strategies . Even though all these studies showed a significant reactivation rate of CMV infection in patients undergoing ASCT, CMV disease was a rare event, although representing a serious life‐threatening risk, with a clinical course and mortality rates similar to those observed after allo‐HSCT .…”

Section: Cytomegalovirus Infection In Autologous Hematopoietic Stem Cmentioning

confidence: 97%

“…40,41 Subsequently, other reports confirmed the relevance of this issue, although reporting a variable rate of incidence ranging between 30 to 40% and 1 to 13%, according to different diagnostic strategies. 5,[42][43][44][45][46][47][48][49] Even though all these studies showed a significant reactivation rate of CMV infection in patients undergoing ASCT, CMV disease was a rare event, although representing a serious life-threatening risk, with a clinical course and mortality rates similar to those observed after allo-HSCT. 1 3,7,8,39,52,[54][55][56][57][58][59] Of note, overt CMV disease incidence and mortality appear similar irrespective to the diagnostic strategy adopted, further suggesting the limited usefulness of a prospective monitoring of CMV infection.…”

Section: Cytomegalovirus Infection In Autologous Hematopoietic Stemmentioning

confidence: 99%

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Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant

Marchesi¹,

Pimpinelli

Ensoli

et al. 2017

Hematological Oncology

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Cytomegalovirus (CMV) infection in clinical settings other than the allogeneic transplant represents a poorly explored issue. Thus, we performed a comprehensive review of the medical literature about CMV infection in patients undergoing autologous hematopoietic stem cell transplant and in other nontransplant-related hematologic patients. In autologous hematopoietic stem cell transplant, a CMV reactivation is reported to occur in up to 41% of CMV seropositive patients, when a prospective monitoring of antigenemia and/or viremia by polymerase chain reaction was adopted. However, more contained frequencies, up to 12%, have been reported when the monitoring criteria were based on a clinically driven diagnostic strategy. The most relevant risk factors appear to be CD34 + selected autografts, total body irradiation, and prior treatment with Alemtuzumab, Fludarabine, or Bortezomib, respectively. Other possible risk factors (ie, prior treatment with Rituximab, T-cell lymphomas, and pretransplant HBcIgG seropositivity) are still debated. In nontransplant settings, the data are very heterogeneous; thus, CMV infection incidence and risk factors are more difficult to establish. Overall, the rate of CMV infection/reactivation ranges between 2 and 67%. High-dose steroids, advanced disease, poor performance status, and treatment with Alemtuzumab, Fludarabine, Bortezomib, and Rituximab appear as the most relevant, though putative, risk factors. Intravenous Ganciclovir represents the gold standard for first-line treatment of CMV infection in these patients. Oral Valganciclovir and Foscarnet are other possible options. Extensive prophylaxis and preemptive therapy are not generally recommended, with the exception of high-risk patients.

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Section: Cytomegalovirus Infection In Autologous Hematopoietic Stem Cmentioning

confidence: 97%

Section: Cytomegalovirus Infection In Autologous Hematopoietic Stemmentioning

confidence: 99%

Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant

Marchesi¹,

Pimpinelli

Ensoli

et al. 2017

Hematological Oncology

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“…Infections are major contributors to morbidity and mortality in PBSCT. In hematological malignancies, CD34‐selected autologous PBSCT has been reported to increase incidences of opportunistic infections compared with non‐CD34‐selected autologous PBSCT (7–11). Most AD patients had undergone immunosuppressive therapy, including cyclosporine and corticosteroids, before transplantation.…”

mentioning

confidence: 99%

Infectious complications in patients receiving autologous CD34‐selected hematopoietic stem cell transplantation for severe autoimmune diseases

Kohno

Nagafuji

Tsukamoto

et al. 2009

Transplant Infectious Dis

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Long-term analysis of infectious complication after high-dose immunosuppressive therapy with CD34-selected autologous hematopoietic stem cell transplantation for patients with severe autoimmune diseases (AD) was performed. Theoretically, CD34 selection can reduce the risk of reinfusion of autoreactive lymphocytes. However, it is also associated with a significant reduction in T cells, natural killer cells, and monocytes, which in turn may compromise immune reconstitution, thereby increasing the risk of infection. Moreover, AD compromises host immunity and causes organ damage resulting in dysfunction of the cutaneous or mucosal barrier. In this study, the incidence rate of infections is reported in 14 patients who underwent high-dose (200 mg/kg) cyclophosphamide therapy followed by reinfusion of CD34-selected autologous peripheral blood stem cells. Bacterial complication occurred in 3 of 14 (21%) patients. Cytomegalovirus reactivation and adenovirus hemorrhagic cystitis were observed in 9 (64%) and 2 (14%) patients, respectively. As for late infectious complications, 7 patients (50%) developed dermatomal varicella zoster virus infection. No infection-related mortality was seen in this case series. Because the risk for infections approaches that seen in allogeneic transplant recipients, infection surveillance, diagnostic workup, and prophylactic strategies similar to those applicable to allogeneic recipients are warranted.

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“…Several studies, including placebo-controlled studies and meta-analyses (but not focused on ASCT patients) showed that acyclovir is useful to prevent and treat HSV and VZV diseases [ 70 , 71 ]. Thus, we strongly recommend acyclovir prophylaxis for at least 6 months, in particular, if CD34-selected grafts are used [ 34 , 72 ]. Inactivated VZV vaccine is strongly recommended for all seropositive HDC/ASCT patients [ 69 ].…”

Section: Methodsmentioning

confidence: 99%

Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

et al. 2020

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To ensure the safety of high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT), evidence-based recommendations on infectious complications after HDC/ASCT are given. This guideline not only focuses on patients with haematological malignancies but also addresses the specifics of HDC/ASCT patients with solid tumours or autoimmune disorders. In addition to HBV and HCV, HEV screening is nowadays mandatory prior to ASCT. For patients with HBs antigen and/or anti-HBc antibody positivity, HBV nucleic acid testing is strongly recommended for 6 months after HDC/ASCT or for the duration of a respective maintenance therapy. Prevention of VZV reactivation by vaccination is strongly recommended. Cotrimoxazole for the prevention of Pneumocystis jirovecii is supported. Invasive fungal diseases are less frequent after HDC/ASCT, therefore, primary systemic antifungal prophylaxis is not recommended. Data do not support a benefit of protective room ventilation e.g. HEPA filtration. Thus, AGIHO only supports this technique with marginal strength. Fluoroquinolone prophylaxis is recommended to prevent bacterial infections, although a survival advantage has not been demonstrated.

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Virus reactivation in high-risk non-Hodgkin’s lymphoma patients after autologous CD34+-selected peripheral blood progenitor cell transplantation

Cited by 6 publications

References 26 publications

Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant

Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant

Infectious complications in patients receiving autologous CD34‐selected hematopoietic stem cell transplantation for severe autoimmune diseases

Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO)

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