Opportunistic virus DNA levels after pediatric stem cell transplantation: serostatus matching, anti-thymocyte globulin, and total body irradiation are additive risk factors
Artikel i vetenskaplig tidskrift, 2011

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.

viral infections

hematopoietic stem cell transplantation

Författare

Carola Kullberg-Lindh

Göteborgs universitet

Karin Mellgren

Göteborgs universitet

Vanda Friman

Göteborgs universitet

Anders Fasth

Göteborgs universitet

Henry Ascher

Göteborgs universitet

Staffan Nilsson

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

Magnus Lindh

Göteborgs universitet

Transplant Infectious Disease

1398-2273 (ISSN) 1399-3062 (eISSN)

Vol. 13 2 122-130

Ämneskategorier

Pediatrik

Immunologi inom det medicinska området

DOI

10.1111/j.1399-3062.2010.00564.x

PubMed

21457420