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Infections after Transplant

Risk factors for late cytomegalovirus infection after allogeneic stem cell transplantation using HLA-matched sibling donor: donor lymphocyte infusion and previous history of early CMV infection

Bone Marrow Transplantation volume 34, pages 21–27 (2004)Cite this article

Summary:

An increased incidence of late cytomegalovirus (CMV) infection has been reported during the last decade since the introduction of ganciclovir (GCV) prophylaxis or GCV pre-emptive therapy. Given that a donor lymphocyte infusion (DLI) can induce more severe GVHD, this may predispose a patient to late CMV infection. In all, 64 patients (median age 36, M/F 38/26) underwent allogeneic stem cell transplantation (SCT) using a matched sibling donor with bone marrow (n=9) or peripheral blood stem cells (n=55). The overall incidence of CMV infection, early and late CMV infection was 46.9 (30/64), 42.2 (27/64), and 16.4% (9/55), respectively. Early CMV infection was treated with GCV pre-emptive therapy that produced a 92.6% success rate. Among the 20 patients who received 35 DLIs, late CMV infection developed in eight (42.1%) of 19 evaluable cases with a median onset at 127 days post transplant. Risk factors for late CMV infection in a logistic regression analysis included DLIs (P=0.001) and a previous history of CMV infection (P=0.006). In conclusion, late CMV infection was strongly associated with DLIs and a previous history of early CMV infection. Accordingly, extended surveillance of CMV antigenemia is recommended for patients receiving DLIs or who have a previous history of CMV infection.

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Acknowledgements

The valuable work of our nursing staff is gratefully acknowledged.

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Authors and Affiliations

  1. Department of Hematology/Oncology, Kyungpook National University Hospital, Daegu, 700-721, Korea

    D H Kim, J G Kim, W J Sung, S K Sohn & K B Lee

  2. Department of Laboratory Medicine, Kyungpook National University Hospital, Daegu, 700-721, Korea

    N Y Lee & J S Suh

  3. Stem Cell Transplantation Center, Kyungpook National University Hospital, Daegu, 700-721, Korea

    D H Kim, J G Kim, S K Sohn, J S Suh, K S Lee & K B Lee

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  1. D H Kim
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Correspondence to S K Sohn.

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Kim, D., Kim, J., Lee, N. et al. Risk factors for late cytomegalovirus infection after allogeneic stem cell transplantation using HLA-matched sibling donor: donor lymphocyte infusion and previous history of early CMV infection. Bone Marrow Transplant 34, 21–27 (2004). https://doi.org/10.1038/sj.bmt.1704528

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