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Infectious Complications

The risk of early and late CMV DNAemia associated with Campath use in stem cell transplant recipients

Bone Marrow Transplantation volume 45, pages 1212–1219 (2010)Cite this article

Abstract

The risks associated with in vivo and ex vivo use of Campath-1H and -1G in a cohort of 206 stem cell transplant recipients for human CMV (HCMV) DNAemia have been quantified. DNAemia showed a biphasic incidence pattern with an inflexion at day 60. The first phase had a linear risk rate for HCMV DNAemia of 0.3% per day, whereas the second phase had a substantially lower risk rate of 0.058% per day. In multivariable analyses, risk factors for early DNAemia were HCMV serostatus, radiotherapy-based conditioning and CD34 stem cell dose, with the use of in vivo Campath-1H having the most significant risk (hazards ratio=3.68; 95% CI=2.02–6.72; P<0.001). Ex vivo use of Campath was not associated with an increased risk for HCMV DNAemia. Patients receiving either in vivo Campath-1H or -1G experienced HCMV DNAemia earlier (27 and 33 days, respectively) compared with patients receiving no Campath (time to DNAemia, 51 days; P=0.0006). Multivariable analysis of risk factors for HCMV DNAemia occurring beyond 100 days after transplant were older age, acute GVHD>grade II and a lower CD34 stem cell dose, whereas Campath-1H use was not associated with late HCMV DNAemia.

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Acknowledgements

This work was supported in part by a Wellcome Trust programme grant and a UK Medical research Council Centre Grant.

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Authors and Affiliations

  1. Department of Infection, Centre for Virology, UCL, London, UK

    H C Buyck, P D Griffiths & V C Emery

  2. Department of Haematology, UCL and the Royal Free Hampstead NHS Trust, London, UK

    H C Buyck & H G F Prentice

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  1. H C Buyck
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Correspondence to V C Emery.

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Buyck, H., Prentice, H., Griffiths, P. et al. The risk of early and late CMV DNAemia associated with Campath use in stem cell transplant recipients. Bone Marrow Transplant 45, 1212–1219 (2010). https://doi.org/10.1038/bmt.2009.329

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