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Risk Factors for Progression from Cytomegalovirus Viremia to Cytomegalovirus Disease after Allogeneic Hematopoietic Stem Cell Transplantation

Authors
 Ji Eun Jang  ;  Shin Young Hyun  ;  Yun Deok Kim  ;  Sul Hee Yoon  ;  Doh Yu Hwang  ;  Soo Jeong Kim  ;  Yuri Kim  ;  Jin Seok Kim  ;  June-Won Cheong  ;  Yoo Hong Min 
Citation
 BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION, Vol.18(6) : 881-886, 2012 
Journal Title
 BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION 
ISSN
 1083-8791 
Issue Date
2012
MeSH
Adolescent ; Adult ; Antiviral Agents/administration & dosage* ; Cytomegalovirus/drug effects ; Cytomegalovirus/physiology ; Cytomegalovirus Infections/complications ; Cytomegalovirus Infections/prevention & control* ; Cytomegalovirus Infections/virology ; Disease Progression ; Drug Administration Schedule ; Female ; Hematopoietic Stem Cell Transplantation* ; Humans ; Leukopenia/complications ; Leukopenia/virology ; Male ; Middle Aged ; Neutropenia/complications ; Neutropenia/virology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Survival Analysis ; Transplantation Conditioning* ; Transplantation, Homologous ; Viremia/complications ; Viremia/prevention & control* ; Viremia/virology
Keywords
CMV disease ; allo-HSCT ; Leukopenia ; Prediction
Abstract
Cytomegalovirus (CMV) disease is a major cause of infectious complications in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Although patients undergoing allo-HSCT receive prophylactic and preemptive treatment for CMV, a subset of patients experience clinically significant CMV disease. This study investigated the risk factors for progression from CMV viremia to CMV disease during or after preemptive therapy in patients undergoing allo-HSCT. Between January 2006 and August 2010, 43 patients received preemptive therapy for CMV viremia after allo-HSCT. These patients experienced 74 episodes of CMV viremia. Nine of the patients (21%) and 12 of the episodes (16%) progressed to CMV disease. Univariate analysis identified several risk factors for progression to CMV disease, including high initial viral load (P = .020), leukopenia (P = .012), and neutropenia (P = .033) at the time of detection of CMV viremia. On multivariate analysis, leukopenia remained an independent predictor (hazard ratio, 4.347; P = .045). The rate of failure to clear CMV viremia after 1 cycle of preemptive therapy was higher in the leukopenia group than in the non-leukopenia group (60.0% versus 16.9%; P = .002). This indicates that leukopenia initially documented with CMV viremia is related to lower viral response to preemptive therapy and is a notable risk factor for progression from CMV viremia to CMV disease.
Full Text
http://www.sciencedirect.com/science/article/pii/S1083879111004629
DOI
22062802
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Soo Jeong(김수정) ORCID logo https://orcid.org/0000-0001-8859-3573
Kim, Yu Ri(김유리) ORCID logo https://orcid.org/0000-0001-5505-0142
Kim, Yun Deok(김윤덕) ORCID logo https://orcid.org/0000-0002-5336-7936
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
Min, Yoo Hong(민유홍) ORCID logo https://orcid.org/0000-0001-8542-9583
Yoon, Sul Hee(윤설희)
Jang, Ji Eun(장지은) ORCID logo https://orcid.org/0000-0001-8832-1412
Cheong, June-Won(정준원) ORCID logo https://orcid.org/0000-0002-1744-0921
Hyun, Shin Yong(현신영)
Hwang, Doh Yu(황도유)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89721
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