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Infections Post Transplant

Cytomegalovirus infections in allogeneic stem cell recipients after reduced-intensity or myeloablative conditioning assessed by quantitative PCR and pp65-antigenemia

Bone Marrow Transplantation volume 32, pages 695–701 (2003)Cite this article

Summary:

Since the incidence of cytomegalovirus (CMV) infections after hematopoietic stem cell transplantation (HSCT) may depend on the intensity of the pretreatment, we studied the incidence of CMV infections after reduced-intensity compared to myeloablative conditioning. A total of 82 patients with matched related or unrelated donors were prospectively monitored for CMV infections after HSCT by CMV-PCR techniques, CMV-antigenemia and clinical observation. A total of 45 patients received reduced-intensity conditioning consisting of fludarabine, busulfan and ATG and 37 patients received myeloablative conditioning. Leukocyte engraftment occurred after a median of 15 vs 18 days (P=0.012) and platelet engraftment after 12 days vs 20 days (P=0.001), respectively. Acute graft-versus-host disease (GVHD) grade II–IV was observed in 58 vs 54% patients (P=0.737), respectively. The onset and peak values of CMV-antigenemia and DNAemia and the incidence of CMV infections did not differ statistically significantly between the two treatment groups. Multivariate analysis confirmed CMV seropositivity of the recipient (P=0.035), acute GVHD II–IV (P=0.001) but not the type of conditioning as significant risk factors for CMV-antigenemia. In conclusion, the kinetics of CMV-antigenemia and DNAemia and the incidence of CMV infections were not statistically different in patients who received HSCT after reduced-intensity conditioning with fludarabine, busulfan and ATG compared to myeloablative conditioning.

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Acknowledgements

We would like to thank Delia Barz for excellent technical assistance.

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Authors and Affiliations

  1. Charité Campus Virchow Klinikum, Humboldt-Universität zu Berlin, Medizinische Klinik m.S. Hämatologie und Onkologie, Berlin, Germany

    J Schetelig & J Oertel

  2. Charité Campus Mitte, Humboldt-Universität zu Berlin, Medizinische Klinik II m.S. Onkologie und Hämatologie, Berlin, Germany

    O Oswald, N Steuer, A Radonic, S Thulke, A Nitsche & W Siegert

  3. Charité Campus Buch, Robert-Rössle Klinik, Medizinische Klinik mit Schwerpunkt Onkologie, Hämatologie und Tumorimmunologie, Germany

    T K Held

  4. Robert Koch-Institut, Berlin, Germany

    A Nitsche

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  1. J Schetelig
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Schetelig, J., Oswald, O., Steuer, N. et al. Cytomegalovirus infections in allogeneic stem cell recipients after reduced-intensity or myeloablative conditioning assessed by quantitative PCR and pp65-antigenemia. Bone Marrow Transplant 32, 695–701 (2003). https://doi.org/10.1038/sj.bmt.1704164

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