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Post-Transplant Events

High-grade cytomegalovirus antigenemia after hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 36, pages 813–819 (2005)Cite this article

Summary:

Clinical impact of high-grade (HG) cytomegalovirus (CMV) antigenemia after hematopoietic stem cell transplantation has not been clarified. Therefore, in order to investigate the risk factors and outcome for HG-CMV antigenemia, we retrospectively analyzed the records of 154 Japanese adult patients who underwent allogeneic hematopoietic stem cell transplantation for the first time from 1995 to 2002 at the University of Tokyo Hospital. Among 107 patients who developed positive CMV antigenemia at any level, 74 received risk-adapted preemptive therapy with ganciclovir (GCV), and 17 of these developed HG-antigenemia defined as ⩾50 positive cells per two slides. The use of systemic corticosteroids at ⩾0.5 mg/kg/day at the initiation of GCV was identified as an independent significant risk factor for HG-antigenemia. Seven of the 17 HG-antigenemia patients developed CMV disease, with a cumulative incidence of 49.5%, which was significantly higher than that in the low-grade antigenemia patients (4%, P<0.001). However, overall survival was almost equivalent in the two groups. In conclusion, the development of HG-antigenemia appeared to depend on the profound immune suppression of the recipient. Although CMV disease frequently developed in HG-antigenemia patients, antiviral therapy could prevent a fatal outcome.

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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. Department of Cell Therapy & Transplantation Medicine, University of Tokyo, Tokyo, Japan

    Y Asano-Mori, K Oshima, M Sakata-Yanagimoto, M Nakagawa, K Kandabashi, K Izutsu, A Hangaishi, T Motokura, S Chiba, M Kurokawa, H Hirai & Y Kanda

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  1. Y Asano-Mori
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  2. K Oshima
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Correspondence to Y Kanda.

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Asano-Mori, Y., Oshima, K., Sakata-Yanagimoto, M. et al. High-grade cytomegalovirus antigenemia after hematopoietic stem cell transplantation. Bone Marrow Transplant 36, 813–819 (2005). https://doi.org/10.1038/sj.bmt.1705134

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  • DOI: https://doi.org/10.1038/sj.bmt.1705134

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