Pre-emptive therapy against cytomegalovirus (CMV) disease guided by CMV antigenemia assay after allogeneic hematopoietic stem cell transplantation: a single-center experience in Japan

Bone Marrow Transplantation
Y KandaY Takaue

Abstract

From April 1998 to March 2000, a cytomegalovirus (CMV) antigenemia-guided pre-emptive approach for CMV disease was evaluated in 77 adult patients who received allogeneic hematopoietic stem cell transplantation at the National Cancer Center Hospital. A CMV antigenemia assay was performed at least once a week after engraftment. High-level antigenemia was defined as a positive result with 10 or more positive cells per 50 000 cells and low-level antigenemia was defined as less than 10 positive cells. Among the 74 patients with initial engraftment, 51 developed positive antigenemia. Transplantation from alternative donors and the development of grade II-IV GVHD were independent risk factors for positive antigenemia. Ganciclovir was administered as pre-emptive therapy in 39 patients in a risk-adapted manner. None of the nine low-risk patients with low-level antigenemia as their initial positive result developed high-level antigenemia even though ganciclovir was withheld. Only one patient developed early CMV disease (hepatitis) during the study period. CMV antigenemia resolved in all but two cases, in whom ganciclovir was replaced with foscarnet. In eight patients, however, the neutrophil count decreased to 0.5 x 10(9)/l or less after...Continue Reading

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Citations

Mar 6, 2008·International Journal of Hematology·Yuki Asano-MoriMineo Kurokawa
Jan 17, 2009·International Journal of Hematology·Katsuto TakenakaUNKNOWN for Fukuoka Blood and Marrow Transplant Group (FBMTG)
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Mar 18, 2016·Journal of Research in Pharmacy Practice·Bahareh ValadkhaniArdeshir Ghavamzadeh
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Feb 19, 2015·Intestinal research·Jaeyoung ChunJong Pil Im
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Apr 24, 2007·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Tomoko MatsumuraShuichi Taniguchi

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