title: [Quantitative monitoring of blood cytomegalovirus after allogeneic hematopoietic stem cell transplantation and its clinical significance].
abstract: OBJECTIVE
  To investigate the risk factor for cytomegalovirus (CMV) viremia and its impact on the survival of patients after allogeneic hematological stem cell transplantation (allo-HSCT).
  
  
  METHODS
  Quantitative fluorescence PCR was used to examine the quantity of CMV in mononuclear cells. All patients were tested weekly after allo-HSCT within 3 months. Univariate and multivariate analysis were used to determine the risk factors of CMV viremia. Five-year overall survival rate was compared and analyzed between the patients with or without CMV viremia.
  
  
  RESULTS
  The incidence of CMV viremia was 72.1% (132/183). Of which, 59.1% (78/132) occurred post one month after transplantation, 40.9% (54/132) occurred within one month and 27.9% (51/183) sustained negative within three months. Two cases were clearly diagnosed as CMV disease with a incidence of 1.1%. Both univariate and multivariate analysis indicated that transplant methods and blood cyclosporine A (CsA) concentration were significantly correlated with CMV viremia. When pairwise compared the results between the different transplant methods, significant differences of CMV viremia were found between human leukocyte antigen (HLA) matched sibling and HLA mismatched relatives, unrelative donor or cord blood (all P values < 0.05). There was no significant difference between HLA mismatched relatives and unrelative donor or cord blood. Further analysis showed that the incidence of CMV viremia was much higher in those who had used antithymocyte globulin (ATG) then those not used ATG. The Kaplan-Meier survival curve showed there was no significant difference between the groups with and without CMV viremia.
  
  
  CONCLUSIONS
  The incidence of CMV viremia after allo-HSCT is 72.1%. Administration of ATG during conditioning regimen and blood CsA concentration > 300 µg/L are the main risk factors for CMV viremia. There is no significant effect of CMV viremia on the cumulative overall survival, while prompt treatment of CMV viremia is a crucial way to prevent CMV disease.
authors.affiliation: Department of Hematology, the First Hospital of Peking University, Beijing 100034, China.
authors.forename: Zhi-Xiang
authors.initials: ZX
authors.lastname: Qiu
authors.forename: Mang-Ju
authors.initials: MJ
authors.lastname: Wang
authors.forename: Li-Hong
authors.initials: LH
authors.lastname: Wang
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Sun
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Jin-Ping
authors.initials: JP
authors.lastname: Ou
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Dong
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Ze-Yin
authors.initials: ZY
authors.lastname: Liang
authors.forename: Xi-Nan
authors.initials: XN
authors.lastname: Cen
authors.forename: Han-Yun
authors.initials: HY
authors.lastname: Ren
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D014184:Transplantation, Homologous / Q000009:adverse effects; D014766:Viremia / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D055815:Young Adult