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Opportunistic virus DNA levels after pediatric stem cell transplantation: serostatus matching, anti-thymocyte globulin, and total body irradiation are additive risk factors

Carola Kullberg-Lindh ; Karin Mellgren ; Vanda Friman ; Anders Fasth ; Henry Ascher ; Staffan Nilsson (Institutionen för matematiska vetenskaper, matematisk statistik) ; Magnus Lindh
Transplant infectious disease : an official journal of the Transplantation Society (1399-3062). Vol. 13 (2011), 2, p. 122-130.
[Artikel, refereegranskad vetenskaplig]

Viral opportunistic infections remain a threat to survival after stem cell transplantation (SCT). We retrospectively investigated infections caused by cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus type 6 (HHV6), or adenovirus (AdV) during the first 6-12 months after pediatric SCT. Serum samples from 47 consecutive patients were analyzed by quantitative real-time polymerase chain reaction assay. DNAemia at any time point occurred for CMV in 47%, for EBV in 45%, for HHV6 in 28%, and for AdV in 28%. Three patients (6.3%) died of CMV-, EBV-, or AdV-related complications 4, 9, and 24 weeks after SCT, respectively, representing 21% of total mortality. These 3 cases were clearly distinguishable by DNAemia increasing to high levels. Serum positivity for CMV immunoglobulin G in either recipient or donor at the time of SCT, total body irradiation, and anti-thymocyte globulin conditioning were independent risk factors for high CMV or EBV DNA levels. We conclude that DNAemia levels help to distinguish significant viral infections, and that surveillance and prophylactic measures should be focused on patients with risk factors in whom viral complications rapidly can become fatal.

Nyckelord: viral infections, hematopoietic stem cell transplantation



Denna post skapades 2012-01-17. Senast ändrad 2015-01-16.
CPL Pubid: 153289

 

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Institutioner (Chalmers)

Institutionen för kliniska vetenskaper, sektionen för kvinnors och barns hälsa, Avdelningen för pediatrik (GU)
Institutionen för biomedicin, avdelningen för infektionssjukdomar (GU)
Institutionen för matematiska vetenskaper, matematisk statistik (2005-2016)

Ämnesområden

Immungenetik
Pediatrik

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