The Effect of Preemptive Therapy with Intravenous Ganciclovir Followed by Oral Ganciclovir against Cytomegalovirus Infection after Allogeneic Peripheral Blood Stem Cell Transplantation / 대한혈액학회지
Korean Journal of Hematology
; : 31-37, 2002.
Article
em Ko
| WPRIM
| ID: wpr-720562
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Recently, in vitro studies demonstrated faster immune reconstitution after allogeneic peripheral blood stem cell transplantation (PBSCT) compared to bone marrow transplantation (BMT). In consequence, it can be expected that better immune reconstitution against cytomegalovirus (CMV) will lead to a reduced CMV-related morbidity and mortality after allogeneic PBSCT.METHODS:
Forty seven patients who received allogeneic PBSCT were enrolled. CMV was routinely sought by at least weekly screening for CMV-related matrix protein pp65 antigenemia after engraftment (WBC >1,500/nL) was achieved. CMV antigenemia was treated with ganciclovir 5mg/kg twice daily i.v. as preemptive therapy for at least 10 days. After then, ganciclovir i.v. was switched to oral ganciclovir for maintenance therapy.RESULTS:
CMV antigenemia was detected 8 (17%) out of 47 patients and CMV disease developed in only 1 case (2.1%). The medianperiod of time until the detection of CMV antigenemia was 51.5 days (range, 35~230). In 7 out of 8 cases, CMV antigenemia disappeared with ganciclovir treatment in 7 days. One patient with CMV disease (CMV interstitial pneumonitis) showed persistent CMV antigenemia for 3 months and expired due to restrictive lung disease.CONCLUSION:
The incidence of CMV antigenemia and resistance to ganciclovir treatment was lower than the incidence of those reported in allogeneic BMT trials. These findings suggest that faster immune reconstitution against CMV after allogeneic PBSCT might have a stronger role in the prevention of emergence of CMV antigenemia and ganciclovir treatment than after allogeneic BMT.Palavras-chave
Texto completo:
1
Índice:
WPRIM
Assunto principal:
Ganciclovir
/
Programas de Rastreamento
/
Incidência
/
Mortalidade
/
Transplante de Medula Óssea
/
Infecções por Citomegalovirus
/
Citomegalovirus
/
Transplante de Células-Tronco de Sangue Periférico
/
Pneumopatias
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
/
Screening_studies
Limite:
Humans
Idioma:
Ko
Revista:
Korean Journal of Hematology
Ano de publicação:
2002
Tipo de documento:
Article