Verma A, Devine S, Morrow M, Chen Y-H, Mihalov M, Peace D, Stock W, Pursell K, Wickrema A, Yassine M, Jessop E, van Besien K
Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, 60637, USA.
Bone Marrow Transplant. 2003 May;31(9):813-6. doi: 10.1038/sj.bmt.1703916.
To establish the incidence of CMV viremia after allogeneic blood stem cell transplantation, we studied 51 consecutive allogeneic peripheral blood stem cell (PBSC) transplant recipients. A total of 12 recipients were at moderate risk for CMV disease and 39 were at high risk. Conditioning regimens varied, but GvHD prophylaxis consisted of tacrolimus and mini-methotrexate in all patients. All patients received prophylactic ganciclovir from admission until day -2 and prophylactic acyclovir from day -1 until day 180 after transplantation. CMV viremia was treated with ganciclovir. Using a PCR-based technique, the cumulative incidence of CMV viremia was 31+/-14% by day 100 and 35+/-14% by day 150. Donor type, CMV risk group, underlying disorder, conditioning regimen, GvHD, and steroid use were not associated with the risk for CMV viremia. No cases of CMV disease occurred. We hypothesize that the low rate of CMV viremia and the absence of CMV disease in this cohort of PBSCT transplant recipients, which contrasts with other reports, may be related to the prophylactic use of high-dose acyclovir and possibly to pretransplant use of ganciclovir.
为确定异基因造血干细胞移植后巨细胞病毒（CMV）血症的发生率，我们研究了51例连续接受异基因外周血干细胞（PBSC）移植的受者。共有12例受者发生CMV疾病的风险为中度，39例为高度。预处理方案各不相同，但所有患者的移植物抗宿主病（GvHD）预防均采用他克莫司和小剂量甲氨蝶呤。所有患者从入院至移植后第-2天接受预防性更昔洛韦治疗，从移植后第-1天至第180天接受预防性阿昔洛韦治疗。CMV血症采用更昔洛韦治疗。采用基于聚合酶链反应（PCR）的技术，至第100天时CMV血症的累积发生率为31±14%，至第150天时为35±14%。供者类型、CMV风险组、基础疾病、预处理方案、GvHD及类固醇使用与CMV血症风险无关。未发生CMV疾病病例。我们推测，与其他报道相反，该组PBSCT移植受者中CMV血症发生率低且无CMV疾病发生，可能与高剂量阿昔洛韦的预防性使用以及可能与移植前使用更昔洛韦有关。
