Evaluation of CMV/human herpes virus-6 positivity in bronchoalveolar lavage fluids as early detection of acute GVHD following BMT: evidence of a significant relationship.
We evaluated the relationship between CMV and human herpes virus-6 (HHV-6) reactivation and the incidence of grades 2 to 4 acute GVHD post BMT. Bronchoalveolar lavage fluid (BALF) samples extracted from 54 BMT recipients on post-BMT day 35 were analyzed by PCR for detection of CMV DNA, HHV-6 DNA and CMV plus HHV-6 DNA. CMV DNA was detected in 26 patients and 13 (50%) developed grades 2 to 4 acute GVHD. Of the 28 who were CMV negative, only six (21.4%) developed grades 2 to 4 acute GVHD. HHV-6 was detected in 18 patients, and 11 (61.1%) developed grades 2 to 4 acute GVHD. Of the 36 who were HHV-6 negative, only eight (22.2%) developed grades 2 to 4 acute GVHD. CMV and HHV-6 were detected in 13 patients, and eight (61.5%) developed grades 2 to 4 acute GVHD. Of the 23 who were negative for both CMV and HHV-6, only three (13%) developed grades 2 to 4 acute GVHD. In all experiments, the difference between the groups was significant (P<0.05, P<0.05 and P<0.01, respectively). We conclude that herpes virus infection, in particular CMV concurrent with HHV-6 reactivation, is predictive of moderate to severe acute GVHD.
Second Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
Y
Y
Takemoto
H
H
Takatsuka
H
H
Wada
A
A
Mori
K
K
Saheki
M
M
Okada
S
S
Tamura
Y
Y
Fujimori
T
T
Okamoto
E
E
Kakishita
A
A
Kanamaru
D000293:Adolescent; D000328:Adult; D000741:Anemia, Aplastic / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000276:immunology*; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis*; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis*; D006566:Herpesviridae Infections / Q000175:diagnosis*; D015654:Herpesvirus 6, Human / Q000302:isolation & purification*; D006801:Humans; D016867:Immunocompromised Host; D007938:Leukemia / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009196:Myeloproliferative Disorders / Q000628:therapy
D004279:DNA, Viral