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Infections Post Transplant

Extended antigenemia surveillance and late cytomegalovirus infection after allogeneic BMT

Bone Marrow Transplantation volume 28, pages 1053–1059 (2001)Cite this article

Abstract

Late CMV disease remains a major concern in allogeneic BMT recipients. Few surveillance data are available on the occurrence of CMV infection and recurrences after day +100. We evaluated the occurrence of antigenemia (AG) recurrences until day +365 in 76 patients who received pre-emptive ganciclovir (GCV) therapy prompted by AG ⩾2 positive cells. Sixty-two episodes of AG recurrences were detected in 33 of the 52 patients who had positive AG. Survival analysis showed a 45.4% probability of AG recurrence on day +100, 64.8% on day +180 and 71.2% on day +365. The median time for AG recurrences was 113 (35 to 343) days. Thirty-five of the 62 episodes (56.4%) occurred after day +100. More than 70% of the patients responded to a 2-week course of GCV and no CMV disease was observed shortly after discontinuation of GCV. The Cox proportional model showed a significant effect of AG recurrences on patient's follow-up only when the patient developed chronic GVHD (P = 0.012). Extended surveillance favored early introduction of GCV and late CMV pneumonia occurred in only one of the 76 patients (1.3%). AG recurrences are frequent after day +100 and extended surveillance until day +365 is recommended for patients who develop chronic GvHD.

Bone Marrow Transplantation (2001) 28, 1053–1059.

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Acknowledgements

This work was supported by FAPESP Grant 98/04493-0. The authors thank the BMT attending doctors RL Silva and RS Saboya and the nurses IF da Rocha and B Diomede, for providing excellent patient care. We appreciate the expert technicians of the Virology Laboratory of Instituto de Medicina Tropical de São Paulo, without whose support this study would not have been possible.

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Authors and Affiliations

  1. Virology Laboratory (LIM 52-HCFMUSP) of Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil

    CM Machado, LS Vilas Boas & CS Pannuti

  2. BMT Program, Fundação Pró Sangue Hemocentro de São Paulo, Discipline of Hematology, University of São Paulo Medical School, São Paulo, Brazil

    CM Machado, MCA Macedo, AVA Mendes & FL Dulley

  3. Discipline of Medical Informatics (LIM 01-HCFMUSP), University of São Paulo Medical School, São Paulo, Brazil

    RX Menezes

  4. Pathology Department of INCOR-HC, University of São Paulo Medical School, São Paulo, Brazil

    JB Castelli

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  1. CM Machado
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Machado, C., Menezes, R., Macedo, M. et al. Extended antigenemia surveillance and late cytomegalovirus infection after allogeneic BMT. Bone Marrow Transplant 28, 1053–1059 (2001). https://doi.org/10.1038/sj.bmt.1703282

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