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The clinical utility of CMV surveillance cultures and antigenemia following bone marrow transplantation.

Abstract：

:At our institution, the cytomegalovirus (CMV) prophylaxis protocol for allogeneic bone marrow transplant (BMT) recipients who are CMV-seropositive or receive marrow from a CMV-seropositive donor consists of a surveillance bronchoscopy approximately 35 days posttransplant. Patients with a positive surveillance bronchoscopy for CMV receive pre-emptive ganciclovir. In order to determine the utility of other screening methods for CMV, we prospectively performed weekly CMV antigenemia, and blood, urine and throat cultures from time of engraftment to day 120 post-BMT in 126 consecutive patients. Pre-emptive ganciclovir was given to 11/81 patients (13.6%) because of a positive surveillance bronchoscopy for CMV. Results of CMV blood, urine and throat cultures and the antigenemia assay done prior to or at the time of the surveillance bronchoscopy were analyzed for their ability to predict the bronchoscopy result. The antigenemia test had the highest positive and negative predictive values (72% and 96%, respectively). The ability of these tests to predict CMV disease was evaluated in the 70 patients with a negative surveillance bronchoscopy who did not receive pre-emptive ganciclovir. Of 19 cases of active CMV disease, CMV antigenemia was positive in 15 patients (79%) a mean of 34 days preceding symptoms. Blood cultures were positive in 14/19 patients (74%) a mean of 31 days before onset of disease. CMV antigenemia is useful for predicting the surveillance bronchoscopy result, and also predicts the development of CMV disease in the majority of patients missed by the surveillance bronchoscopy.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Humar A,O'Rourke K,Lipton J,Messner H,Meharchand J,Mahony J,Walker I,Wasi P,McGeer A,Moussa G,Chua R,Mazzulli T

doi

10.1038/sj.bmt.1701525

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

45-51

issue

1

eissn

0268-3369

issn

1476-5365

journal_volume

23

pub_type

临床试验,杂志文章

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