Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation: Comparison of an antigenemia assay and quantitative real-time polymerase chain reaction

K. Yakushiji, H. Gondo, K. Kamezaki, K. Shigematsu, S. Hayashi, M. Kuroiwa, S. Taniguchi, Y. Ohno, K. Takase, A. Numata, K. Aoki, K. Kato, K. Nagafuji, K. Shimoda, T. Okamura, N. Kinukawa, N. Kasuga, M. Sata, M. Harada

Research output: Contribution to journalArticle

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Abstract

Cytomegalovirus (CMV) antigenemia and quantitative real-time polymerase chain reaction (PCR) were compared for monitoring of CMV reactivation after allogeneic stem cell transplantation. The number of CMV antigen-positive cells by the antigenemia assay and the level of CMV DNA by real-time PCR correlated well. The sensitivity and specificity of the antigenemia assay was 55.4% and 95.5%, respectively, using real-time PCR as the reference standard. The probability of positive antigenemia at day 100 was 76.5%, with a median of first detection at day 37 in 51 patients, compared with a positive PCR of 84.3% and day 33, respectively. When HLA-identical sibling donor transplant recipients and other donor transplant recipients were analyzed separately, there was no difference between the two tests. However, temporal patterns of first detection of CMV antigen-positive cells and CMV DNA differed between HLA-identical and alternative recipients; patients without CMV (29%) or with sporadic positive PCR results (14%) were more common in HLA-identical sibling transplants, wereeas patients with simultaneous antigenemia and positive PCR occurred more in alternative transplants (48%). Two of 51 patients (4%) developed CMV colitis despite antigenemia-guided prophylaxis, but both were successfully treated with ganciclovir. Although PCR is more sensitive than antigenemia, both tests are useful in the early detection of CMV after allogeneic stem cell transplantation.

Original languageEnglish
Pages (from-to)599-606
Number of pages8
JournalBone Marrow Transplantation
Volume29
Issue number7
DOIs
Publication statusPublished - Jan 1 2002

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Stem Cell Transplantation
Cytomegalovirus
Real-Time Polymerase Chain Reaction
Polymerase Chain Reaction
Siblings
Tissue Donors
Transplants
Antigens
Ganciclovir
DNA
Colitis
Sensitivity and Specificity

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation : Comparison of an antigenemia assay and quantitative real-time polymerase chain reaction. / Yakushiji, K.; Gondo, H.; Kamezaki, K.; Shigematsu, K.; Hayashi, S.; Kuroiwa, M.; Taniguchi, S.; Ohno, Y.; Takase, K.; Numata, A.; Aoki, K.; Kato, K.; Nagafuji, K.; Shimoda, K.; Okamura, T.; Kinukawa, N.; Kasuga, N.; Sata, M.; Harada, M.

In: Bone Marrow Transplantation, Vol. 29, No. 7, 01.01.2002, p. 599-606.

Research output: Contribution to journalArticle

Yakushiji, K, Gondo, H, Kamezaki, K, Shigematsu, K, Hayashi, S, Kuroiwa, M, Taniguchi, S, Ohno, Y, Takase, K, Numata, A, Aoki, K, Kato, K, Nagafuji, K, Shimoda, K, Okamura, T, Kinukawa, N, Kasuga, N, Sata, M & Harada, M 2002, 'Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation: Comparison of an antigenemia assay and quantitative real-time polymerase chain reaction', Bone Marrow Transplantation, vol. 29, no. 7, pp. 599-606. https://doi.org/10.1038/sj.bmt.1703513
Yakushiji, K. ; Gondo, H. ; Kamezaki, K. ; Shigematsu, K. ; Hayashi, S. ; Kuroiwa, M. ; Taniguchi, S. ; Ohno, Y. ; Takase, K. ; Numata, A. ; Aoki, K. ; Kato, K. ; Nagafuji, K. ; Shimoda, K. ; Okamura, T. ; Kinukawa, N. ; Kasuga, N. ; Sata, M. ; Harada, M. / Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation : Comparison of an antigenemia assay and quantitative real-time polymerase chain reaction. In: Bone Marrow Transplantation. 2002 ; Vol. 29, No. 7. pp. 599-606.
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abstract = "Cytomegalovirus (CMV) antigenemia and quantitative real-time polymerase chain reaction (PCR) were compared for monitoring of CMV reactivation after allogeneic stem cell transplantation. The number of CMV antigen-positive cells by the antigenemia assay and the level of CMV DNA by real-time PCR correlated well. The sensitivity and specificity of the antigenemia assay was 55.4{\%} and 95.5{\%}, respectively, using real-time PCR as the reference standard. The probability of positive antigenemia at day 100 was 76.5{\%}, with a median of first detection at day 37 in 51 patients, compared with a positive PCR of 84.3{\%} and day 33, respectively. When HLA-identical sibling donor transplant recipients and other donor transplant recipients were analyzed separately, there was no difference between the two tests. However, temporal patterns of first detection of CMV antigen-positive cells and CMV DNA differed between HLA-identical and alternative recipients; patients without CMV (29{\%}) or with sporadic positive PCR results (14{\%}) were more common in HLA-identical sibling transplants, wereeas patients with simultaneous antigenemia and positive PCR occurred more in alternative transplants (48{\%}). Two of 51 patients (4{\%}) developed CMV colitis despite antigenemia-guided prophylaxis, but both were successfully treated with ganciclovir. Although PCR is more sensitive than antigenemia, both tests are useful in the early detection of CMV after allogeneic stem cell transplantation.",
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AU - Shigematsu, K.

AU - Hayashi, S.

AU - Kuroiwa, M.

AU - Taniguchi, S.

AU - Ohno, Y.

AU - Takase, K.

AU - Numata, A.

AU - Aoki, K.

AU - Kato, K.

AU - Nagafuji, K.

AU - Shimoda, K.

AU - Okamura, T.

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AU - Sata, M.

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