title: Surveillance of CMV infection in allo-HSCT recipients and guidance on preemptive therapy by RQ-PCR.
abstract: In order to study the epidemiological characteristics of cytomegalovirus (CMV) infection in allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients by means of plasma real time quantitative polymerase chain reaction (RQ-PCR), 141 adult patients undergoing allo-HSCT between January 2008 and June 2010 were serially monitored by RQ-PCR for detecting CMV and guiding the preemptive therapy followed up to 180 days post-HSCT. The results showed that the incidence of CMV infection and CMV pneumonia was 81.5% and 2.9% respectively, which mainly occurred within 2 months post-HSCT. Single-therapy with ganciclovir (GCV) for 63 patients or foscarnet 6 patients was performed for preemptive therapy. The total efficacy was 87.8%, and the response patterns were different. CMV infection was more frequent in female patients (P = 0.044), and those with aGVHD (P = 0.043), using ATG or basiliximab in conditioning regimens (P = 0.049), as well as earlier in patients using ATG or basiliximab or those with aGVHD (P = 0.007; P = 0.000). The aGVHD, maximum load, positive times of CMV-DNA detection and therapy duration all correlated with the efficacy (P < 0.05). It is concluded that the incidence of CMV infection is still high after HSCT. Plasma RQ-PCR assay for CMV-DNA shows a strong correlation with the clinical outcome of CMV infection, which is useful and suitable for management of CMV infection in HSCT.
authors.affiliation: Department of Hematology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Li
authors.initials: L
authors.lastname: Gao
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Ding
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Xu
authors.forename: Hong-Hua
authors.initials: HH
authors.lastname: Li
authors.forename: Yu
authors.initials: Y
authors.lastname: Jing
authors.forename: Jian
authors.initials: J
authors.lastname: Bo
authors.forename: Wen-Rong
authors.initials: WR
authors.lastname: Huang
authors.forename: Quan-Shun
authors.initials: QS
authors.lastname: Wang
authors.forename: Chun-Ji
authors.initials: CJ
authors.lastname: Gao
authors.forename: Li
authors.initials: L
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D000998:Antiviral Agents