[Risk factors analysis of cytomegalovirus infection after nonmyeloablative allogeneic peripheral blood stem cell transplantation].
The aim of this study was to analyze the risk factors of cytomegalovirus (CMV) infection and CMV disease after nonmyeloablative allogeneic hematopoietic stem cell transplantation(NST) and develop a rational strategy for the diagnosis, monitoring and preemptive treatment of CMV infection. The Clinical data of 80 patients undergoing NST from November 2009 to November 2012 in the hospital 307 were retrospectively analyzed. The cytomegalovirus load in peripheral blood of patients was detected by using RT-PCR. The results indicated that the incidence of CMV infection was 77.5% (62/80), and the median time for the positive CMV-DNA firstly detected by RT-PCR was day 35 (17-133) after NST. The total of 100-day cumulative incidence of CMV disease was 11.3%(9/80) after early preemptive therapy. Both univariate and multivariate analysis showed thymoglobulin (ATG) used in preconditioning regimen, other herpesvirus infection and fungal infection in medical history before NST were the risk factors of CMV infection after NST.Univariate analysis revealed that CMV viremia and ATG used in preconditioning regimen were the risk factors for CMV disease, while the same result was not found in the multivariate analysis.The incidence of CMV infection in patients with II-IV grade of aGVHD was 91.3%,while the incidence of CMV infection in patients with 0-1 grade of aGVHD was 71.9% (P = 0.06), it seems that II-IV grade of aGVHD was not the risk factor of CMV infection for NST. It is concluded that the ATG used in preconditioning regimen may increase the incidence of both CMV infection and CMV disease after NST. CMV infection easily accompanies by other herpesvirus infection and fungal infection.Therefore other herpesvirus infection and fungal infection should be attentively monitored and prevented after trans-plantation.
Postgraduate School, Anhui Medical University, Hefei 230032, Anhui Province, China; Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China.
Yong-Ping
YP
Zhang
Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China.
Kai-Xun
KX
Hu
Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China.
Qi-Yun
QY
Sun
Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China.
Jian-Hui
JH
Qiao
Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China.
Mei
M
Guo
Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China.
Hui-Sheng
HS
Ai
Department of Hematology, Hospital 307 of Chinese PLA, Beijing 100071, China. E-mail: fische1224@gmail.com.
Chang-Lin
CL
Yu
D000293:Adolescent; D000328:Adult; D000961:Antilymphocyte Serum; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult
D000961:Antilymphocyte Serum; C512542:thymoglobulin