Human cytomegalovirus DNAemia and preemptive treatment of CMV infection in children after hematopoietic stem-cell transplantation: Is any question settled?

ABSTRACT Objective To assess the rate of, and risk factors for, human cytomegalovirus viremia (HCMV) in donor+/recipient+ (HCMV serostatus matched) hematopoietic stem-cell transplantation (HSCT) recipients. Methods HCMV DNA from 144 donor+/recipient+ HSCT recipients was examined by quantitative polymerase chain reaction (qPCR). Results The cumulative incidence of HCMV viremia was 69.4% (100/144) during the 48 weeks after HSCT. In a multivariate analysis, acute graft-versus-host disease (aGVHD) was discovered to be a risk factor for the occurrence of HCMV viremia (P = .006). The cumulative incidence of HCMV viremia and increasing DNA loads were significantly associated with aGVHD occurrence (P = .001 for each). The occurrence of late-term HCMV viremia was associated with aGVHD (P = .001) and a higher DNA load during the first 12 weeks after HSCT (P = .04). Conclusions aGVHD is a risk factor for HCMV viremia. Recipients with aGVHD who have a high HCMV DNA load should be strictly monitored to prevent HCMV activation.

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The results of risk adapted pre-emptive therapy of CMV infection with ganciclovir in 169 patients, after allogeneic hematopoietic stem cell transplantation in Hematology-Oncology and BMT Research Center

Biology of Blood and Marrow Transplantation ◽

10.1016/j.bbmt.2004.12.063 ◽

2005 ◽

Vol 11 (2) ◽

pp. 22

Author(s):

M. Iravani ◽

A.H. Faghih ◽

A.R. Shamshiri ◽

M. Toutounchi ◽

M. Tavakoli ◽

...

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Research Center ◽

Cmv Infection ◽

Hematopoietic Stem

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Cytomegalovirus (CMV) infection after hematopoietic stem cell transplantation: significant progress, but many unresolved problems

Expert Opinion on Biological Therapy ◽

10.1517/14712590902854448 ◽

2009 ◽

Vol 9 (4) ◽

pp. 383-385 ◽

Cited By ~ 5

Author(s):

Alessandro Busca

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Significant Progress ◽

Cmv Infection ◽

Hematopoietic Stem

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The Association of KIR2DS4 and Its Variant KIR1D with CMV Infection after HLA-Matched Sibling Hematopoietic Stem Cell Transplantation

Blood ◽

10.1182/blood.v124.21.2555.2555 ◽

2014 ◽

Vol 124 (21) ◽

pp. 2555-2555

Author(s):

Yao Yao ◽

Xiaoli Li ◽

Liangjing Xu ◽

Bin Liu ◽

Yue Han ◽

...

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Infection Rate ◽

Cmv Infection ◽

Hematopoietic Stem ◽

Platelet Recovery ◽

Matched Sibling

Abstract Objective To expolore the association of KIR2DS4 and its variant KIR1D with cytomegalovirus(CMV) infection after HLA-matched sibling hematopoietic stem cell transplantation. Methods Polymerase chain reaction with sequence-speciﬁc primers (PCR-SSP) method was used to genotype KIR genes in 267 donor-recipient pairs from Oct 2005 to Apr 2014. Posttransplant monitoring for CMV infection was performed by immune histochemically assays .165 donor-recipient pairs who belong to KIR gene haplotype AA were analyzed for the presence of KIR2DS4 and its variant KIR1D and then further subdivided into the following groups: 2DS4-/1D+ (homozygous for the deletion variant KIR1D), 2DS4+/1D+ (heterozygous), 2DS4+/1D- (two intact KIR2DS4 alleles). Furthermore, we investigated the influence of the KIR2DS4 variants on CMV infection of 165 patients receiving Sibling related HLA matched transplantation. Results There were no significant differences in frequency of KIR2DS4 or KIR1D between donors and recipients in the haplotype AA group. The ratio of 2DS4+ and KIR1D in haplotype AA group was 2:1.There was no difference on neutrophil engraftment and platelet recovery among the three groups after hematopoietic stem cell transplantation. The CMV infection rate was significantly higher in 2DS4+/1D- group compared with 2DS4+/1D+ group (44.0% vs 19.0%，P=0.002)．In 2DS4-/1D+ group ，the CMV infection rate was higer than that in 2DS4+KIR1D+ group (50.0% vs 19%，P=0.028). However，there was no difference in CMV infection rate between 2DS4+/1D-group and 2DS4-/1D+ group. Conclusion KIR2DS4 and its variant KIR1D are associated with CMV infection after HLA-matched sibling hematopoietic stem cell transplantation Disclosures No relevant conflicts of interest to declare.

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