Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogeneic bone marrow transplantation

Wingard, John R.; Dy, Chen; Burns, WH; Fuller, DJ; Braine, HG; Yeager, Anne S.; Kaiser, Heather E.; Burke, PJ; Graham, Matthew M.; Gw, Santos

doi:10.1182/blood.v71.5.1432.1432

Cited by 180 publications

(34 citation statements)

References 23 publications

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“…CMV, and particularly CMV pneumonitis, had previously been the most common cause of death in BMT recipients [71], but has declined with aggressive monitoring and treatment of CMV reactivations. Consistently identified risk factors for CMV disease include CMV seropositivity, GVHD, lymphopenia, and use of alemtuzumab [47,[72][73][74].…”

Section: Avian Influenzamentioning

confidence: 99%

Respiratory Infections

Anderson

2014

Infectious Complications in Cancer Patients

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The respiratory tract is a common site of infection in cancer patients and is associated with substantial moribidity and mortality in this population. Cancer, chemotherapy, and radiation can all cause noninfectious pulmonary infiltrates and respiratory symptoms that can masquerade as a respiratory tract infection. Cancer patients are at a particular risk for infection by a wide variety of different viruses, fungi, and bacteria that can be difficult to treat. Although noninvasive diagnostics have significantly improved recently, patients with severe pneumonia and those not responding to usual therapy should be candidates for aggressive diagnostic testing and tissue sampling. Initial therapy should be carefully chosen and individually tailored to account for the individual patient's underlying risk factors for multi-drug-resistant pathogens, viral pathogens, or fungi. Once diagnostic testing returns, therapy should be altered to appropriately narrow the spectrum of coverage.

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Section: Avian Influenzamentioning

confidence: 99%

Respiratory Infections

Anderson

2014

Infectious Complications in Cancer Patients

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“…The most severe presentation is CMV primary infection in a seronegative recipient after receiving a CMV-seropositive transfusion or HSCT [6][7][8]. Usually, primary CMV infection or reactivation occurs more than 50 days after HSCT [3], and it is more frequent in allogeneic than autologous HSCT [9].…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus infection in children undergoing hematopoietic stem cell transplantation in Chile

Paris

Kopp

King

et al. 2009

Pediatric Blood & Cancer

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“…Few authors have studied CMV excretion and pneumonia in autografted patients. However, the mean incidence of CMV pneumonia after autografting remains < 10% (Ljungman et al, 1991(Ljungman et al, , 1994Reusser et al, 1990;Valteau et al, 1988;Wingard et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

Should cytomegalovirus be tested for in both blood and bronchoalveolar lavage fluid of patients at a high risk of CMV pneumonia after bone marrow transplantation?

et al. 1997

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Summary.To identify and treat patients at high risk of cytomegalovirus (CMV) pneumonia after bone marrow transplantation (BMT), we tested for CMV viraemia weekly, and performed broncho-alveolar lavage (BAL) on day 35 post-transplant in 63 recipients. 36 allogeneic BMT recipients were at a high risk of CMV pneumonia (25 CMVseropositive recipients and 11 patients receiving marrow from a CMV-seropositive donor). Patients with a positive BAL or viraemia received a 14 d course of ganciclovir or foscarnet. CMV was detected in 29 (46%) of the 63 BMT recipients and excretion of CMV in blood and BAL was significantly linked. However, among the 29 patients who excreted the virus, only 10 (35%) shed CMV in blood and BAL at the same time; 19 patients (65%) had detectable CMV in blood (11 patients) or BAL (eight patients) only. Therefore, on the basis of viraemia or BAL alone, 21/29 patients (70%) and 18/29 patients (60%), respectively, would have received antiviral treatment. BAL increased the CMV detection rate by 13% (8/63 patients) relative to viraemia. With this strategy, the incidence of CMV pneumonia was reduced to 3% in allografted patients. Only two of the 19 autografted patients developed fatal CMV pneumonia. We avoided anti-CMV treatment in 54% of all the BMT recipients. In conclusion, CMV should be tested for in both blood and BAL fluid of BMT recipients at high risk of CMV pneumonia.

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Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogeneic bone marrow transplantation

Cited by 180 publications

References 23 publications

Respiratory Infections

Respiratory Infections

Cytomegalovirus infection in children undergoing hematopoietic stem cell transplantation in Chile

Should cytomegalovirus be tested for in both blood and bronchoalveolar lavage fluid of patients at a high risk of CMV pneumonia after bone marrow transplantation?

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