The Mexican schedule to conduct allogeneic stem cell transplantation is related to a low risk of cytomegalovirus reactivation and disease.
The prevalence of cytomegalovirus (CMV) reactivation and disease after non-myeloablative stem cell transplantation is largely unknown. Using fludarabine combined with alemtuzumab or antithymocyte globulin in the conditioning regimen, some authors have found increased prevalences of CMV disease, whereas other authors using different schedules have observed decreased prevalences. In a group of 17 individuals allografted using the Mexican conditioning regimen, which employs fludarabine, cyclophosphamide, and busulfan, we assessed CMV reactivation, morbidity, and mortality. Before transplant, IgG anti-CMV antibodies were found in 11 patients and in 10 donors; in 8 cases, both donor and patient had IgG anti-CMV antibodies. In only one case (6%) was CMV mRNA identified 30 days after the allograft during grade IV acute graft-versus-host disease. CMV reactivation, disease, and mortality were very low using our non-myeloablative stem cell transplantation schedule, which has been shown to be useful for allografting with minimal toxicity and reduced costs.
Ruiz-Argüelles
Guillermo J
GJ
Centro de Hematología y Medicina Interna de Puebla, Puebla, Mexico. gruizl@clinicaruiz.com
Rangel
J David Gómez
JD
Ponce-de-León
Samuel
S
González-Déctor
Laura
L
Reyes-Núñez
Virginia
V
Garcés-Eisele
Javier
J
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000956:Antigens, Viral / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods; D014775:Virus Activation / Q000276:immunology
D000914:Antibodies, Viral; D000956:Antigens, Viral; D007074:Immunoglobulin G; D012367:RNA, Viral