Cytomegalovirus (CMV) antigenaemia for rapid diagnosis and monitoring of CMV‐associated disease after bone marrow transplantation

Abstract

A technique for the rapid detection of cytomegalovirus (CMV) antigen-positive blood leucocytes (CMV antigenaemia) was evaluated in 15 marrow transplant patients as a means of diagnosis and for monitoring CMV-associated disease. CMV antigenaemia was determined by direct immunoperoxidase staining of leucocytes with a peroxidase-labelled monoclonal antibody, HRP-C7, which binds an immediate-early antigen of human CMV. CMV antigenaemia occurred in 7/15 marrow transplant patients (47%) and was initially detected between 4 and 6 weeks after transplantation. CMV-associated diseases developed in 3/15 patients (20%). All patients with CMV-associated disease had a relatively large number of CMV antigen-positive leucocytes, exceeding 10 per 50,000 white blood cells (WBCs). In the remaining 12 patients, CMV antigen-positive leucocytes were less than 10 per 50,000 WBCs or were undetectable. CMV-associated disease did not develop in these patients during the period of monitoring. CMV antigen-positive leucocytes were detected more frequently in patients who developed acute graft-versus-host disease (GVHD) or haemorrhagic cystitis than in those without such complications. CMV antigens were detectable from 1 to 4 weeks before the onset of CMV-associated disease which allowed initiation of ganciclovir treatment at an early stage. The degree of CMV antigenaemia paralleled the clinical symptoms and signs, higher degrees of antigenaemia being associated with more significant disease. Thus, the detection of CMV antigen-positive blood leucocytes is useful for the diagnosis and monitoring of CMV-associated disease following bone marrow transplantation.

Foscarnet therapy for ganciclovir-resistant cytomegalovirus retinitis after stem cell transplantation: effective monitoring of CMV infection by quantitative analysis of CMV mRNA

“…18,19 In this study, we monitored and analyzed CMV activities using an NASBA technique, which is highly suited for the amplification of RNA sequences. [7][8][9] We amplified the ␤2.7 transcripts of the CMV, which is detected concomitantly with active viral replication.…”

Thrombotic microangiopathy following allogeneic bone marrow transplantation

“…23,[25][26][27][28] Other actions which have been reported include induction of vascular permeability factor, 25 release of other cytokines (such as TNF-␣, IL-8 and IL-2) by induction of natural killer cells and T cells, and aggravation of acute GVHD. 29 In summary, BMT was complicated by TM following exposure to stimuli such as severe GVHD, CMV infection, and high CsA concentrations when patients had become Various cytokines and ICAM-1 were measured five times: before conditioning, day 0 (before bone marrow infusion), during the aplastic phase (days 5-10), during rapid recovery of WBC (days [11][12][13][14][15][16][17][18][19][20], and during the stable phase after WBC recovery and discontinuation of G-CSF (days [21][22][23][24][25][26][27][28]. The only significant difference in cytokines between the patients with and without TM was a marked increase of interleukin-12 (IL-12) that occurred by the WBC recovery phase in the patients with TM (two-way layout analysis of variance; P Ͻ 0.05) (a).…”

Endothelial damage caused by cytomegalovirus and human herpesvirus-6

“…16,17 The direct immunoperoxidase method was also used for CMV antigen screening, employing a peroxidase-labelled monoclonal antibody for viral matrix protein p65 (HRP-C7). 18 The immunoperoxidase method was used for CMV antigen screening of BALF on day 35 and for screening of peripheral blood once weekly until day 100, and then every 2-4 weeks depending on the clinical manifestations until discharge from hospital.…”