Risk-adapted preemptive therapy for cytomegalovirus disease after allogeneic stem cell transplantation: A single-center experience in Korea

被引：25

作者：

Choi, SM ^{[1
]}

Lee, DG ^{[1
]}

Choi, JH ^{[1
]}

Yoo, JH ^{[1
]}

Kim, YJ ^{[1
]}

Park, SH ^{[1
]}

Park, SN ^{[1
]}

Min, CK ^{[1
]}

Lee, S ^{[1
]}

Kim, HJ ^{[1
]}

Kim, DW ^{[1
]}

Lee, JW ^{[1
]}

Min, WS ^{[1
]}

Shin, WS ^{[1
]}

Kim, CC ^{[1
]}

机构：

[1] Catholic Univ Korea, Coll Med, Catholic Hematopoiet Stem Cell Tranplantat Ctr, Seoul, South Korea

来源：

INTERNATIONAL JOURNAL OF HEMATOLOGY | 2005年 / 81卷 / 01期

关键词：

cytome-alovirus; preemptive therapy; ganciclovir; CMV antigenemia;

D O I：

10.1532/IJH97.A30402

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Cytomeaglovirus (CMV) remains a major cause of infection in recipients of hematopoietic stem cell transplants (HSCT) and results in significant mortality and morbidity. We present the results of CMV pp,65 antigenemia-guided, risk-adapted pre-emptive therapy aimed at preventing CMV disease in allogeneic HSCT. Preemptive ganciclovir treatment was Started when more than 5 CMV antigen-positive cells were detected in the low-risk group (with grade 0-1 acute, GVHD and matched related HSCT) and when any antigen-positive cells were seen in the high-risk group (with grade II-IV acute GVHD or matched unrelated HSCT). At least 1 episode of antigenemia was observed in 53 (59.6%) of 89 patients before day 100, and preemptive therapy was performed in 33 patients. CMV disease occurred in 6 patients (5 in the high-risk group and I in the low-risk group). and late CMV disease developed in 4 patients. Only 1 patient died of CMV pneumonitis before day 100. Neutropenia was observed in 51.5% of ganciclovir-treated patients, and coinfection/superinfection was observed in 42.4%. A strategy of ganciclovir treatment focusing on patients at higher risk could reduce the toxicity from the antiviral drug and be cost-effective. Extended surveillance for CMV disease using more Sensitive diagnostic methods is necessary in high-risk patients. (C) 2005 The Japanese Society of Hematology.

引用

页码：69 / 74

页数：6

共 24 条

[1] Successful modification of a pp65 antigenemia-based early treatment strategy for prevention of cytomegalovirus disease in allogeneic marrow transplant recipients [J].