Monitoring of human herpesviruses after allogeneic peripheral blood stem cell transplantation and bone marrow transplantation.
Herpesviruses frequently cause serious complications after allogeneic bone marrow transplantation (allo-BMT). Recent studies have shown more rapid immune reconstitution after allogeneic peripheral blood stem cell transplantation (allo-PBSCT) compared with allo-BMT. However, it has not been clarified whether the improved immune reconstitution after allo-PBSCT is associated with a lower incidence of herpesvirus infections. We monitored the emergence of Epstein-Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus 6 (HHV-6) and HHV-7 DNA by a nested-double polymerase chain reaction in peripheral blood leucocytes from 22 allo-BMT and 16 allo-PBSCT patients. Each virus had an unique temporal profile of detection. HHV-6 DNA was detected most frequently at 3 weeks after transplantation, whereas CMV and EBV DNA were detected later (2-3 months). Detection rates of HHV-6 DNA at 3 and 4 weeks after allo-BMT were significantly higher than those after allo-PBSCT (9/16 v 2/13 at 3 weeks, P < 0.01; 10/21 v 1/15 at 4 weeks, P < 0.01). Detection rates of the other three herpesviruses after the two types of allogeneic transplantation were not significantly different throughout observation period. Furthermore, detection of HHV-6 DNA within the first 4 weeks was associated with delayed platelet engraftment after both allo-BMT and allo-PBSCT (P < 0.01). These results suggest an advantage for allo-PBSCT over allo-BMT in terms of suppression of HHV-6 reactivation and prevention of subsequent complications.
Maeda
Y
Y
Second Department of Internal Medicine, Okayama University Medical School, Okayama, Japan.
Teshima
T
T
Yamada
M
M
Shinagawa
K
K
Nakao
S
S
Ohno
Y
Y
Kojima
K
K
Hara
M
M
Nagafuji
K
K
Hayashi
S
S
Fukuda
S
S
Sawada
H
H
Matsue
K
K
Takenaka
K
K
Ishimaru
F
F
Ikeda
K
K
Niiya
K
K
Harada
M
M
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000379:methods*; D002648:Child; D003587:Cytomegalovirus / Q000302:isolation & purification; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000821:virology; D006402:Hematologic Diseases / Q000628:therapy / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D016199:Herpesvirus 7, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous
D004279:DNA, Viral