Reduced Mortality of Cytomegalovirus Pneumonia After Hematopoietic Cell Transplantation Due to Antiviral Therapy and Changes in Transplantation Practices

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Veronique ErardMichael Boeckh

Abstract

Despite major advances in the prevention of cytomegalovirus (CMV) disease, the treatment of CMV pneumonia in recipients of hematopoietic cell transplant remains a significant challenge. We examined recipient, donor, transplant, viral, and treatment factors associated with overall and attributable mortality using Cox regression models. Four hundred twenty-one cases were identified between 1986 and 2011. Overall survival at 6 months was 30% (95% confidence interval [CI], 25%-34%). Outcome improved after the year 2000 (all-cause mortality: adjusted hazard ratio [aHR], 0.7 [95% CI, .5-1.0]; P = .06; attributable mortality: aHR, 0.6 [95% CI, .4-.9]; P = .01). Factors independently associated with an increased risk of all-cause and attributable mortality included female sex, elevated bilirubin, lymphopenia, and mechanical ventilation; grade 3/4 acute graft-vs-host disease was associated with all-cause mortality only. An analysis of patients who received transplants in the current preemptive therapy era (n = 233) showed only lymphopenia and mechanical ventilation as significant risk factors for overall and attributable mortality. Antiviral treatment with ganciclovir or foscarnet was associated with improved outcome compared with no an...Continue Reading

References

Apr 1, 1992·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·P LjungmanH J Kolb
Jul 1, 1991·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·M BoeckhJ D Meyers
Jan 14, 1988·The New England Journal of Medicine·J D MeyersE D Thomas
Feb 1, 1993·Annals of Internal Medicine·J M GoodrichJ D Meyers
Mar 27, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Per LjungmanCarlos Paya
Mar 9, 2004·Journal of Clinical Microbiology·Michael BoeckhLawrence Corey
Jun 19, 2004·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Takahiro FukudaKieren A Marr
Jan 22, 2005·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ted A GooleyGeorge B McDonald
Aug 4, 2005·Cancer·Roy F ChemalyIssam I Raad
Jan 24, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Arlo UptonKieren A Marr
Sep 14, 2007·Blood Cells, Molecules & Diseases·Hermann EinseleGötz Ulrich Grigoleit
Dec 3, 2008·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·H A TorresR F Chemaly
May 20, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Hirohisa NakamaeMichael Boeckh
May 23, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G BrestrichP Reinke
Jun 12, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Margaret L GreenMichael Boeckh
Sep 27, 2013·The New England Journal of Medicine·Francisco M MartyUNKNOWN CMX001-201 Clinical Study Group
Dec 10, 2013·Hematology·Helen E Heslop, Ann M Leen
May 9, 2014·The New England Journal of Medicine·Roy F ChemalyUNKNOWN AIC246 Study Team
Dec 3, 2014·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Michael BoeckhKarl S Peggs

❮ Previous
Next ❯

Citations

Mar 13, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Yayoi Matsumura-KimotoTakahiro Fukuda
Apr 5, 2016·Expert Review of Hematology·Enrico MaffiniBenedetto Bruno
Nov 1, 2016·Expert Review of Hematology·Franco LocatelliPietro Merli
May 5, 2017·Expert Review of Molecular Diagnostics·Poornima Ramanan, Raymund R Razonable
May 16, 2017·Current Opinion in Infectious Diseases·Shigeo FujiMarkus Kapp
Dec 7, 2017·The New England Journal of Medicine·Francisco M MartyCyrus Badshah
Aug 4, 2018·Journal of Thoracic Imaging·Nobuyuki TanakaNoriyo Yanagawa
Jun 10, 2016·Journal of Clinical Microbiology·N Esther Babady
Dec 14, 2018·Current Opinion in Infectious Diseases·Sanjeet S Dadwal
Jan 29, 2019·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Jose F CamargoMichele I Morris
Jun 4, 2019·International Journal of Molecular Sciences·Sung-Yeon ChoHee-Je Kim
Aug 27, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Joshua A HillMichael Boeckh
Oct 1, 2019·Current Opinion in Infectious Diseases·Fareed KhawajaRoy F Chemaly
Feb 12, 2019·American Journal of Respiratory and Critical Care Medicine·Xiaofeng ZhouBethany B Moore
Sep 27, 2019·Journal of Clinical Microbiology·Meredith L CarpenterBenjamin A Pinsky
Dec 17, 2019·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Jason ChenSanjeet S Dadwal
Dec 13, 2019·Pediatric Hematology and Oncology·Edward KimNahed Abdel-Haq
Jul 2, 2018·Drugs·Atibordee Meesing, Raymund R Razonable
Jan 26, 2020·Current Hematologic Malignancy Reports·Morgan Hakki
Oct 30, 2020·Pathogens·Abigail L Dooley, Christine M O'Connor
Jun 16, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Larisa BroglieMarcelo C Pasquini
Mar 31, 2021·Infection·P PaglianoSilvano Esposito
Aug 8, 2021·Journal of Clinical Medicine·Anna AstashchankaJisha Joshua

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antivirals

Antivirals are medications that are used specifically for treating viral infections. Discover the latest research on antivirals here.

Antivirals (ASM)

Antivirals are medications that are used specifically for treating viral infections. Discover the latest research on antivirals here.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.