[Cytomegalovirus diseases after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and related risk factors].

Abstract

OBJECTIVE:

To analyze the incidence of cytomegalovirus (CMV) diseases after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and related risk factors.

METHODS:

The clinical data of 131 patients undergoing allo-HSCT August 1999 to July 2001 were analyzed retrospectively.

RESULTS:

Twenty-eight of the 131 patients developed CMV interstitial pneumonia (IP) with an incidence rate of 21.35%, 9 patients developed CMV enteritis with an incidence rate of 6.87%; in total 37 of the 131 patients developed CMV disease with the accumulative one-year incidence rate of 32.54%. Thirteen patients (35.14%)died of CMV diseases. Univariate analysis showed that accumulative incidence of CMV disease was associated with unrelated donor, II-IV degrees acute graft versus host disease (aGVHD), additional immunosuppressive therapy for GVHD, chronic graft versus host disease (cGVHD), antilymphocyte globulin (ALG)/monoclonal antibody (MoAb) administration, high dose of methylprednisolone (MP), plasma viramia-PCR (PV-PCR) positivity of patients, blood transfusion and pre-emptive treatment. Multivariate analysis showed that risk factors for CMV disease included plasma CMV-DNA positivity, immense amount of blood transfused, and additional immunosuppressive therapy for aGVHD, and pre-emptive therapy capable of turning PV-PCR positive reduced the incidence of CMV disease (RR: 3.309, 1.046, 2.242, and 0.346).

CONCLUSION:

CMV disease has a high morbidity and mortality in allo-HSCT patients. Patients with positive plasma CMV-DNA should receive pre-emptive therapy till their plasma CMV-DNA turns to be negative, especially in condition of severe aGVHD, immense amount of blood transfused, or additional immunosuppressive therapy.

• Authors: Xiao-jun Huang, Lan-ping Xu, Han-yun Ren, Yao-chen Zhang, Nai-lan Guo, Dao-pei Lu
• Journal: Zhonghua yi xue za zhi (Zhonghua Yi Xue Za Zhi) Vol. 83 Issue 9 Pg. 766-9 (May 10 2003) ISSN: 0376-2491 [Print] China
• PMID: 12899755 (Publication Type: English Abstract, Journal Article)

Chemical References

• DNA, Viral

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• China (epidemiology)
• Cytomegalovirus (isolation & purification)
• Cytomegalovirus Infections (epidemiology, etiology, prevention & control)
• DNA, Viral (blood)
• Female
• Follow-Up Studies
• Graft vs Host Disease (etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Incidence
• Leukemia (surgery)
• Lung Diseases, Interstitial (epidemiology, virology)
• Male
• Middle Aged
• Multivariate Analysis
• Retrospective Studies
• Risk Factors
• Transplantation, Homologous