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Viral Infections

Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation: comparison of an antigenemia assay and quantitative real-time polymerase chain reaction

Bone Marrow Transplantation volume 29, pages 599–606 (2002)Cite this article

Abstract

Cytomegalovirus (CMV) antigenemia and quantitative real-time polymerase chain reaction (PCR) were compared for monitoring of CMV reactivation after allogeneic stem cell transplantation. The number of CMV antigen-positive cells by the antigenemia assay and the level of CMV DNA by real-time PCR correlated well. The sensitivity and specificity of the antigenemia assay was 55.4% and 95.5%, respectively, using real-time PCR as the reference standard. The probability of positive antigenemia at day 100 was 76.5%, with a median of first detection at day 37 in 51 patients, compared with a positive PCR of 84.3% and day 33, respectively. When HLA-identical sibling donor transplant recipients and other donor transplant recipients were analyzed separately, there was no difference between the two tests. However, temporal patterns of first detection of CMV antigen-positive cells and CMV DNA differed between HLA-identical and alternative recipients; patients without CMV (29%) or with sporadic positive PCR results (14%) were more common in HLA-identical sibling transplants, whereas patients with simultaneous antigenemia and positive PCR occurred more in alternative transplants (48%). Two of 51 patients (4%) developed CMV colitis despite antigenemia-guided prophylaxis, but both were successfully treated with ganciclovir. Although PCR is more sensitive than antigenemia, both tests are useful in the early detection of CMV after allogeneic stem cell transplantation.

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Acknowledgements

This research was supported by a Grant-in-Aid for Scientific Research from the Ministry of Health, Labor and Welfare.

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Authors and Affiliations

  1. Second Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan

    K Yakushiji, T Okamura & M Sata

  2. Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

    H Gondo, K Kamezaki, K Takase, A Numata, K Aoki, K Kato, K Nagafuji, K Shimoda, T Okamura & M Harada

  3. Department of Hematology, Harasanshin General Hospital, Fukuoka, Japan

    K Shigematsu & S Hayashi

  4. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    M Kuroiwa & S Taniguchi

  5. Department of Internal Medicine, Kitakyushu Municipal Hospital, Kitakyushu, Japan

    Y Ohno

  6. Department of Medical Information Science, Kyushu University Hospital, Fukuoka, Japan

    N Kinukawa

  7. Otsuka Assay Laboratories, Otsuka Pharmaceutical Co., Tokyo, Japan

    N Kasuga

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Yakushiji, K., Gondo, H., Kamezaki, K. et al. Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation: comparison of an antigenemia assay and quantitative real-time polymerase chain reaction. Bone Marrow Transplant 29, 599–606 (2002). https://doi.org/10.1038/sj.bmt.1703513

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