[Usefulness of quantitative PCR in biopsy specimens for early therapeutic intervention in gastro-intestinal cytomegalovirus infections after allogeneic stem cell transplantation].
Gastro-intestinal cytomegalovirus infection (GI-CMV), which occurs after allogeneic stem cell transplantation (allo-SCT), is diagnosed by immunostaining of biopsied tissues obtained using a fiberscope. However, the sensitivity of this pathological diagnostic test is poor. We evaluated the suitability of using quantitative polymerase chain reaction (qPCR) to test GI-mucosal tissues for CMV. We analyzed adult patients who had undergone allo-SCT at our institute. Twenty-seven specimens were collected from patients undergoing GI-fibers-copy for upper GI-symptoms after allo-SCT. Of these patients, 9 tested positive for CMV by qPCR; their symptoms resolved soon after receiving antiviral therapies for CMV. Pathological procedures detected GI-CMV in only 3 cases. In contrast, CMV qPCR was positive for 12 of 30 specimens collected from patients with lower GI-symptoms by using colon fibers-copy. Antiviral therapies were effective in all but one case. GI-CMV was diagnosed pathologically in only 5 cases. Therefore, CMV qPCR is effective for early therapeutic intervention in CMV-GI patients after allo-SCT.
Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University.
Yasuyuki
Y
Arai
Tadakazu
T
Kondo
Toshiyuki
T
Kitano
Masakatsu
M
Hishizawa
Kouhei
K
Yamashita
Norimitsu
N
Kadowaki
Akifumi
A
Takaori-Kondo
D000328:Adult; D000368:Aged; D001706:Biopsy; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D061345:Early Medical Intervention; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000473:pathology / Q000821:virology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult