Details

Autor(en) / Beteiligte

• NAKAI, K
• KANDA, Y
• MAKIMOTO, A
• TANOSAKI, R
• KUNITOH, H
• TOBINAI, K
• TAKAUE, Y
• MINEISHI, S
• SAITO, T
• OHNISHI, M
• NIIYA, H
• CHIZUKA, A
• TAKEUCHI, T
• MATSUBARA, H
• KAMI, M

Titel

Suspected delayed immune recovery against cytomegalovirus after reduced-intensity stem cell transplantation using anti-thymocyte globulin

Ist Teil von

• Bone marrow transplantation (Basingstoke), 2002-02, Vol.29 (3), p.237-241

Ort / Verlag

Basingstoke: Nature Publishing Group

Erscheinungsjahr

2002

Quelle

MEDLINE

Beschreibungen/Notizen

• A reduced-intensity hematopoietic stem cell transplantation (RIST) regimen was developed to induce immunosuppression to facilitate the engraftment of donor cells. However, there have been concerns that the incidence of opportunistic infection may increase after this procedure. To address this problem, we retrospectively analyzed the medical records of 24 RIST recipients who were treated over a recent 16-month period for comparison with 31 recipients of conventional allogeneic transplantation (CST). The RIST regimen consisted of cladribine (0.66 mg/kg), busulfan (8 mg/kg), and rabbit anti-thymocyte globulin (ATG; 5-10 mg/kg). All of the patients received allogeneic peripheral blood stem cells from an HLA-identical or one-locus mismatched related donor. Although the incidence of positive CMV antigenemia was comparable between the two groups (58% vs 68%), RIST patients developed positive antigenemia significantly sooner than did CST patients (P = 0.01) and showed higher initial and maximum antigenemia values (P = 0.026 and P = 0.003, respectively). These findings may suggest that immune recovery against CMV was delayed after our RIST procedure, but this did not directly translate into an increase in clinically significant CMV disease. Early therapeutic intervention with ganciclovir might play a role in preventing the progression of early CMV infection to CMV disease.