Influence of antithymocyte globulin dose on outcome in cytomegalovirus-seropositive recipients of partially T cell-depleted stem cell grafts from matched-unrelated donors.
The adverse impact of positive-recipient Cytomegalovirus (CMV) serostatus on the outcome of matched-unrelated donor (MUD) grafts has been stressed. We evaluated whether CMV-seropositive MUD recipients transplanted after 1999 still showed inferior outcome compared with CMV-seronegative recipients. Two important changes in transplantation procedure were introduced in 1999: (1) reduction of antithymocyte globulin dose, (2) introduction of sequence-based typing of HLA-DRB1. Thirty-six patients received partial T cell-depleted grafts before 1999, and 44 after 1999. CMV-seropositive patients transplanted before 1999 showed a highly significant inferior outcome compared with seronegative recipients. In contrast, no difference in outcome was observed between the two groups of patients transplanted after 1999.
Meijer
Ellen
E
Department of Haematology, University Medical Centre, Utrecht, the Netherlands. emeijer@digd.azu.nl
Dekker
Adriaan W
AW
Verdonck
Leo F
LF
D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum / Q000008:administration & dosage*; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000150:complications*; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007938:Leukemia / Q000276:immunology / Q000601:surgery* / Q000821:virology*; D018655:Lymphocyte Count; D008875:Middle Aged; D012044:Regression Analysis; D033581:Stem Cell Transplantation / Q000379:methods*; D015996:Survival Rate; D013601:T-Lymphocytes / Q000276:immunology; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014775:Virus Activation
D000961:Antilymphocyte Serum; D000998:Antiviral Agents; D015774:Ganciclovir