期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 17, 期 11, 页码 1602-1611出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2011.08.014
关键词
Cytomegalovirus (CMV); CMV DNA load in plasma; Self-resolving episodes of active CMV infection; CMV doubling time; Kinetics of CMV DNA load decline; Preemptive antiviral therapy
资金
- FIS (Fondo de Investigaciones Sanitarias, Ministerio de Sanidad y Consumo, Spain) [09/1117]
Preemptive antiviral therapy strategies for active cytomegalovirus (CMV) infection occurring in allogeneic stem cell transplant recipients should be optimized to avoid overtreatment. The current study was aimed at determining whether the analysis of the kinetics of CMV DNA load in plasma may provide useful information for the therapeutic management of active CMV infection in this setting. A total of 59 consecutive patients were included in the study, of which 40 (67.8%) developed 1 (n = 21) or more (n = 19) episodes of CMV DNAemia. The need for antiviral therapy for initial or secondary episodes of CMV DNAemia could not be predicted on the basis of the CMV DNA load value in the first plasma testing positive by polymerase chain reaction (PCR). In contrast, in the absence of antiviral therapy, an increase of >= 3-fold between the baseline CMV DNA load and that measured a median of 6 days later discriminated between initial episodes eventually requiring antiviral treatment and those resolving spontaneously (sensitivity, 76.4%; specificity, 89.4%; positive predictive value, 86.6%; negative predictive value, 80.9%). This criterion was not useful for identifying recurrent episodes of CMV DNAemia that required antiviral therapy. The CMV doubling time and CMV DNA loads at the time of the first positive PCR and at initiation of preemptive therapy did not differ significantly between episodes that responded immediately to antiviral therapy from those showing a delayed response. The analysis of the dynamics of CMV DNA load in plasma in the absence of antiviral therapy allowed early recognition of episodes of CMV DNAemia that eventually needed to be treated, but did not permit prediction of the kinetics of CMV DNA clearance in response to antiviral therapy. Biol Blood Marrow Transplant 17: 1602-1611 (2011) (C) 2011 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