Korean J Hematol 2002; 37(1):
Published online March 31, 2002
© The Korean Society of Hematology
김종광, 성우진, 채의수, 서광운, 박성원, 정진태, 손상균, 서장수, 이규보
경북대학교 의과대학 임상병리학교실,
경북대학교 의과대학 내과학교실
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/㎕) was achieved. CMV antigenemia was treated with ganciclovir 5 ㎎/㎏ 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 median period 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.
Keywords Cytomegalovirus; CMV antigenemia; Allogeneic PBSCT; Preemptive therapy;
Korean J Hematol 2002; 37(1): 31-37
Published online March 31, 2002
Copyright © The Korean Society of Hematology.
김종광, 성우진, 채의수, 서광운, 박성원, 정진태, 손상균, 서장수, 이규보
경북대학교 의과대학 임상병리학교실,
경북대학교 의과대학 내과학교실
Jong Gwang Kim, Woo Jin Sung, Yi Soo Che, Kwang Woon Seo, Sung Won Park, Jin Tae Jung, Sang Kyun Sohn, Jang Soo Suh, Kyu Bo Lee
Department of Internal Medicine, Clincal Pathology, Kyungpook National University, School of Medicine, Daegu, Korea
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/㎕) was achieved. CMV antigenemia was treated with ganciclovir 5 ㎎/㎏ 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 median period 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.
Keywords: Cytomegalovirus, CMV antigenemia, Allogeneic PBSCT, Preemptive therapy,