title: Gastrointestinal cytomegalovirus disease in patients with cancer: a two decade experience in a tertiary care cancer center.
abstract: Although gastrointestinal cytomegalovirus disease (GI-CMVd) is not common in cancer patients, it is associated with high morbidity and mortality. Herein, we review our 2-decade experience with GI-CMVd in such patient population at The University of Texas M.D. Anderson Cancer Center. Forty-seven patients were identified. Thirty-four patients (72%) had an underlying haematological malignancy, and 18 patients (38%) developed GI-CMVd following hematopoietic stem cell transplantation (HSCT). Nine (25%) of the 36 cancer patients with data available had AIDS. Upper-GI tract involvement was more common in patients with haematological malignancies than in those with solid tumours (P=0.02). Patients with AIDS were more likely to have colonic involvement than were those without AIDS (67% vs. 15%, P=0.006), and patients without AIDS were more likely to have gastric involvement (59% vs. 11%, P=0.01). The CMV-attributable mortality rate was 42%. Independent predictors of death by multivariate analysis included disseminated CMV and AIDS (P<0.01). The presentation of GI-CMVd varies according to the type of cancer, and AIDS. GI-CMVd is associated with a high mortality among cancer patients, particularly those with disseminated CMV disease or AIDS.
authors.affiliation: Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas, Unit 402, M.D. Anderson Cancer Center, Houston, TX 77030-4009, USA.
authors.forename: Harrys A
authors.initials: HA
authors.lastname: Torres
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Kontoyiannis
authors.forename: Gerald P
authors.initials: GP
authors.lastname: Bodey
authors.forename: Javier A
authors.initials: JA
authors.lastname: Adachi
authors.forename: Mario A
authors.initials: MA
authors.lastname: Luna
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Tarrand
authors.forename: Graciela M
authors.initials: GM
authors.lastname: Nogueras
authors.forename: Issam I
authors.initials: II
authors.lastname: Raad
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004338:Drug Combinations; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D012189:Retrospective Studies
chemical_list: D000998:Antiviral Agents; D004338:Drug Combinations