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The risk of cytomegalovirus infection in non-myeloablative peripheral stem cell transplantation compared with conventional bone marrow transplantation.

Oh SJ, Lee KH, Lee JH, Choi SJ, Kim WK, Lee JS, Kim MN - J. Korean Med. Sci. (2004)

Bottom Line: The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40), and two groups showed similar initial and maximal antigenemia values (p=0.56 and p=0.68, respectively).Only one case of CMV colitis developed in the CBT group whereas CMV disease did not develop in the NST group.Although statistically insignificant, the treatment response against CMV antigenemia using ganciclovir was in favor of NST group.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Division of Oncology-Hematology, Seoul, Korea.

ABSTRACT
Non-myeloablative allogeneic peripheral stem cell transplantation (NST) is a novel therapeutic strategy for patients with hematologic malignancies. Whether non-myeloablative transplants are associated with increased risk of cytomegalovirus (CMV) infections is unknown. To clarify this issue, we compared the outcome of CMV infection following 24 allogeneic non-myeloablative peripheral blood stem cell transplants and 40 conventional bone marrow transplants (CBT). The NST regimen consisted (mg/kg). Twelve patients (50%) in the NST group and 17 (43%) in the CBT group developed positive antigenemia before day 100 (p=0.60). The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40), and two groups showed similar initial and maximal antigenemia values (p=0.56 and p=0.68, respectively). Only one case of CMV colitis developed in the CBT group whereas CMV disease did not develop in the NST group. Although statistically insignificant, the treatment response against CMV antigenemia using ganciclovir was in favor of NST group. In conclusion, there was no difference in the risk of CMV infection between NST group and CBT group. Further prospective and controlled study is needed to clarify the impact of non-myeloablative procedure on the outcome of CMV infection.

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Probability of developing positive CMV antigenemia after non-myeloablative and conventional transplantation shown by Kaplan-Meier curves.
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Figure 1: Probability of developing positive CMV antigenemia after non-myeloablative and conventional transplantation shown by Kaplan-Meier curves.

Mentions: In the NST group, 12 patients (50%) developed antigenemia at a median onset of 44 days (range 12-97). Seventeen patients (43%) developed CMV antigenemia at a median onset of 47 days (range 20-75) in the CBT group. The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40, Fig. 1). The median number of initial CMV antigen value of NST group was 4 (range 1-110) and that of CBT group was 4 (range 1-190). The median number of maximal CMV antigen of NST group was 8 (range 1-110) and that of CBT group was 7 (range 1-190). There was no significant difference in the degree of initial and maximal CMV antigen value between NST group and CBT group (Fig. 2).


The risk of cytomegalovirus infection in non-myeloablative peripheral stem cell transplantation compared with conventional bone marrow transplantation.

Oh SJ, Lee KH, Lee JH, Choi SJ, Kim WK, Lee JS, Kim MN - J. Korean Med. Sci. (2004)

Probability of developing positive CMV antigenemia after non-myeloablative and conventional transplantation shown by Kaplan-Meier curves.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822295&req=5

Figure 1: Probability of developing positive CMV antigenemia after non-myeloablative and conventional transplantation shown by Kaplan-Meier curves.
Mentions: In the NST group, 12 patients (50%) developed antigenemia at a median onset of 44 days (range 12-97). Seventeen patients (43%) developed CMV antigenemia at a median onset of 47 days (range 20-75) in the CBT group. The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40, Fig. 1). The median number of initial CMV antigen value of NST group was 4 (range 1-110) and that of CBT group was 4 (range 1-190). The median number of maximal CMV antigen of NST group was 8 (range 1-110) and that of CBT group was 7 (range 1-190). There was no significant difference in the degree of initial and maximal CMV antigen value between NST group and CBT group (Fig. 2).

Bottom Line: The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40), and two groups showed similar initial and maximal antigenemia values (p=0.56 and p=0.68, respectively).Only one case of CMV colitis developed in the CBT group whereas CMV disease did not develop in the NST group.Although statistically insignificant, the treatment response against CMV antigenemia using ganciclovir was in favor of NST group.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Division of Oncology-Hematology, Seoul, Korea.

ABSTRACT
Non-myeloablative allogeneic peripheral stem cell transplantation (NST) is a novel therapeutic strategy for patients with hematologic malignancies. Whether non-myeloablative transplants are associated with increased risk of cytomegalovirus (CMV) infections is unknown. To clarify this issue, we compared the outcome of CMV infection following 24 allogeneic non-myeloablative peripheral blood stem cell transplants and 40 conventional bone marrow transplants (CBT). The NST regimen consisted (mg/kg). Twelve patients (50%) in the NST group and 17 (43%) in the CBT group developed positive antigenemia before day 100 (p=0.60). The time to the first appearance of positive antigenemia was not different between these two groups (p=0.40), and two groups showed similar initial and maximal antigenemia values (p=0.56 and p=0.68, respectively). Only one case of CMV colitis developed in the CBT group whereas CMV disease did not develop in the NST group. Although statistically insignificant, the treatment response against CMV antigenemia using ganciclovir was in favor of NST group. In conclusion, there was no difference in the risk of CMV infection between NST group and CBT group. Further prospective and controlled study is needed to clarify the impact of non-myeloablative procedure on the outcome of CMV infection.

Show MeSH
Related in: MedlinePlus