A randomized controlled trial of plasma real-time PCR and antigenemia assay for monitoring CMV infection after unrelated BMT

Y. Kanda, T. Yamashita, T. Mori, T. Ito, K. Tajika, S. Mori, T. Sakura, M. Hara, K. Mitani, M. Kurokawa, K. Akashi, M. Harada

研究成果: Contribution to journalArticle査読

32 被引用数 (Scopus)

抄録

Preemptive therapy is the standard strategy for preventing CMV disease after allogeneic hematopoietic SCT. In this study, unrelated BMT recipients were randomly assigned to a plasma real-time PCR group or an antigenemia group to compare the value of these monitoring tools for CMV reactivation. Ganciclovir (GCV) was started at 5 mg/kg/day when PCR reached 300 copies per ml or when antigenemia reached three positive cells per two slides. A total of 88 patients were randomized into the antigenemia group (n45) or the PCR group (n43). A significantly higher number of patients reached the threshold in the antigenemia group than in the PCR group (73.3 vs 44.2%, P0.0089). However, only three patients (one in the antigenemia group and two in the PCR group) developed early CMV disease. These patients exclusively had colitis and were successfully treated with GCV or foscarnet. The median number of antigenemia-positive cells at the start of GCV was 47 in the PCR group. These findings suggest that antigenemia assay with the current cutoff was too sensitive and led to unnecessary use of GCV. However, the appropriateness of the threshold may be different by the methodology used, and therefore, it is difficult to generalize.

本文言語英語
ページ(範囲)1325-1332
ページ数8
ジャーナルBone Marrow Transplantation
45
8
DOI
出版ステータス出版済み - 8 2010

All Science Journal Classification (ASJC) codes

  • 血液学
  • 移植

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