期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 24, 期 10, 页码 2094-2100出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2018.05.008
关键词
Transplant; Cord blood; CMV; Prevention; Prophylaxis
资金
- National Institutes of Health [HL088021, CA78902, CA18029, HL122173, P50 HL110787-05, 5K23AI119133-03, K24HL093294]
We previously demonstrated a lower rate of cytomegalovirus (CMV) reactivation and disease among seropositive umbilical cord blood transplantation (CBT) recipients receiving an intensive prophylaxis strategy consisting of ganciclovir on days -8 to -2 pretransplantation, high-dose valacyclovir post-transplantation, and twice-weekly serum CMV polymerase chain reaction testing. We hypothesized that a modified intensive strategy excluding pre transplantation ganciclovir would be similarly effective. We compared the risk of CMV reactivation, occurrence of CMV disease, and duration of anti-CMV therapy by day 100 post-CBT in patients receiving the modified intensive and intensive strategies. Forty patients received the modified intensive strategy, and 43 received the intensive strategy. There was no difference in the hazard for CMV reactivation (hazard ratio, 1.1; P=.77). No patients in the modified intensive cohort, but 2 patients in the intensive cohort, developed CMV disease (P=.53). There was no difference in the hazard for early (<= 30 days post-CBT; P=.76) or high-level (>1000IU/mL; P=.37) CMV reactivation. Patients in the modified intensive cohort had marginally higher CMV viral loads and percentage of days of CMV detection and treatment, although the contribution of pretransplantation ganciclovir to these differences is unclear. The overall percentage of treatment days was 32% in both cohorts after accounting for pretransplantation ganciclovir. In conclusion, exclusion of prophylactic ganciclovir before CBT did not impact the risk of CMV reactivation or disease, although CMV kinetics appeared to differ by prevention strategy. Best practices for CMV prevention will need further study as new prophylactic strategies become available. (C) 2018 American Society for Blood and Marrow Transplantation.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据