Surveillance of CMV infection in allo-HSCT recipients and guidance on preemptive therapy by RQ-PCR.

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.

• Authors: Yan Li, 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
• Journal: Zhongguo shi yan xue ye xue za zhi (Zhongguo Shi Yan Xue Ye Xue Za Zhi) Vol. 21 Issue 1 Pg. 161-8 (Feb 2013) ISSN: 1009-2137 [Print] China
• PMID: 23484712 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Antiviral Agents

Topics

• 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