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Murine Reconstruction

Suspected delayed immune recovery against cytomegalovirus after reduced-intensity stem cell transplantation using anti-thymocyte globulin

Bone Marrow Transplantation volume 29, pages 237–241 (2002)Cite this article

Abstract

A reduced-intensity hematopoietic stem cell transplantation (RIST) regimen was developed to induce immunosuppression to facilitate the engraftment of donor cells. However, there have been concerns that the incidence of opportunistic infection may increase after this procedure. To address this problem, we retrospectively analyzed the medical records of 24 RIST recipients who were treated over a recent 16-month period for comparison with 31 recipients of conventional allogeneic transplantation (CST). The RIST regimen consisted of cladribine (0.66 mg/kg), busulfan (8 mg/kg), and rabbit anti-thymocyte globulin (ATG; 5–10 mg/kg). All of the patients received allogeneic peripheral blood stem cells from an HLA-identical or one-locus mismatched related donor. Although the incidence of positive CMV antigenemia was comparable between the two groups (58% vs 68%), RIST patients developed positive antigenemia significantly sooner than did CST patients (P = 0.01) and showed higher initial and maximum antigenemia values (P = 0.026 and P = 0.003, respectively). These findings may suggest that immune recovery against CMV was delayed after our RIST procedure, but this did not directly translate into an increase in clinically significant CMV disease. Early therapeutic intervention with ganciclovir might play a role in preventing the progression of early CMV infection to CMV disease.

Bone Marrow Transplantation (2002) 29, 237–241. doi:10.1038/sj.bmt.1703351

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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. Stem Cell Transplant Unit, National Cancer Center Hospital, Tokyo, Japan

    K Nakai, Y Kanda, S Mineishi, T Saito, M Ohnishi, H Niiya, A Chizuka, T Takeuchi, H Matsubara, M Kami, A Makimoto, R Tanosaki & Y Takaue

  2. Department of Pulmonary Oncology, National Cancer Center Hospital, Tokyo, Japan

    H Kunitoh

  3. Hematology Division, National Cancer Center Hospital, Tokyo, Japan

    K Tobinai

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Nakai, K., Kanda, Y., Mineishi, S. et al. Suspected delayed immune recovery against cytomegalovirus after reduced-intensity stem cell transplantation using anti-thymocyte globulin. Bone Marrow Transplant 29, 237–241 (2002). https://doi.org/10.1038/sj.bmt.1703351

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