Surveillance of CMV infection in allo-HSCT recipients and guidance on preemptive therapy by RQ-PCR.
10.7534/j.issn.1009-2137.2013.01.033
- Author:
Yan LI
1
;
Li GAO
;
Li-Li WANG
;
Yi DING
;
Yuan-Yuan XU
;
Hong-Hua LI
;
Yu JING
;
Jian BO
;
Wen-Rong HUANG
;
Quan-Shun WANG
;
Chun-Ji GAO
;
Li YU
Author Information
1. Department of Hematology, Chinese PLA General Hospital, Beijing, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Antiviral Agents;
therapeutic use;
Child;
Cytomegalovirus;
Cytomegalovirus Infections;
diagnosis;
drug therapy;
etiology;
Female;
Hematopoietic Stem Cell Transplantation;
adverse effects;
Humans;
Male;
Middle Aged;
Polymerase Chain Reaction;
methods;
Retrospective Studies;
Transplantation, Homologous;
Young Adult
- From:
Journal of Experimental Hematology
2013;21(1):161-168
- CountryChina
- Language:English
-
Abstract:
In order to study the epidemiological characteristics of cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients by means of plasma real time quantitative polymerase chain reaction (RQ-PCR), 141 adult patients undergoing allo-HSCT between January 2008 and June 2010 were serially monitored by RQ-PCR for detecting CMV and guiding the preemptive therapy followed up to 180 days post-HSCT. The results showed that the incidence of CMV infection and CMV pneumonia was 81.5% and 2.9% respectively, which mainly occurred within 2 months post-HSCT. Single-therapy with ganciclovir (GCV) for 63 patients or foscarnet 6 patients was performed for preemptive therapy. The total efficacy was 87.8%, and the response patterns were different. CMV infection was more frequent in female patients (P = 0.044), and those with aGVHD (P = 0.043), using ATG or basiliximab in conditioning regimens (P = 0.049), as well as earlier in patients using ATG or basiliximab or those with aGVHD (P = 0.007; P = 0.000). The aGVHD, maximum load, positive times of CMV-DNA detection and therapy duration all correlated with the efficacy (P < 0.05). It is concluded that the incidence of CMV infection is still high after HSCT. Plasma RQ-PCR assay for CMV-DNA shows a strong correlation with the clinical outcome of CMV infection, which is useful and suitable for management of CMV infection in HSCT.
