Cidofovir, a choice for salvage treatment of CMV infection in patients with haploidentical hematopoietic stem cell transplantation

2021 ◽  
Author(s):  
Zhao Yin ◽  
Jing Sun ◽  
Ying Yang ◽  
Na Xu ◽  
Ling Jiang ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Salvage Treatment ◽  
Cmv Infection ◽  
Hematopoietic Stem

scholarly journals The Efficacy and Safety of Cidofovir in Salvage Therapy for CMV Infection in the Patients with Haploid Hematopoietic Stem Cell Transplantation

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5659-5659
Author(s):  
Guo-Pan Yu ◽  
Zhao Yin ◽  
Zhiping Fan ◽  
Fen Huang ◽  
Na Xu ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Salvage Treatment ◽  
Efficacy And Safety ◽  
Cmv Infection ◽  
Hematopoietic Stem ◽  
Median Response

Cidofovir (CDV) is a nucleotide analogue with broad antiviral activity and has been approved for the treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome. Data on the use of CDV for anti-CMV treatment in the patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) are limited. To evaluate the efficacy and safety of CDV in salvage treatment of CMV infection after allo-HSCT, we prospectively enrolled 18 patients with CMV infection after allo-HSCT in this study, of whom failed or intolerant to preemptive antiviral therapy. Dose of CDV as 5 mg/kg per week was used until CMV-DNA negative twice with quantification polymerase chain reaction (qPCR) detection or disease progression. All these 18 patients received haploid HSCT and suffered from a median of II (I~IV) ° acute graft versus host disease (aGVHD) before or at the same time of CMV infection. The patients showed as CMV DNAemia (n=7), CMV syndrome (n=5) and CMV disease (n=6) at a median time of 37 (range, 26 to 49) days post transplantation. Before CDV, all the patients received ganciclovir (n=9) or/and foscarnet (n=10) as pre-empty treatment for CMV infection, and 15 cases failed while 3 untolerated to the side effect. After a median of 2 (1-4) course of CDV therapy, 14 (77.8%) patients acquired clinical cure, 1 improved, and 3 (16.7%) failed, presenting a median response time of 2 courses. 11 (61.1%) patients had a 1-log decrease in CMV-DNA copy number after 1 cycle of CDV treatment, and 10 (55.6%) patients obtained virus clearance after 1 to 2 courses of treatment. With a median follow-up of 5 (1 to 12) months, 14 patients remained continuously CMV-DNA negative. During CDV treatment, 4 (22.2%) patients developed mild reversible renal damage and 5 (27.8%) experienced I~II° gastrointestinal reactions. Taking together, it could be effective and safe to use cidofovir in salvage treatment for CMV infection in the patients with allo-HSCT, including haplo-HSCT. Disclosures No relevant conflicts of interest to declare.

scholarly journals The Association of KIR2DS4 and Its Variant KIR1D with CMV Infection after HLA-Matched Sibling Hematopoietic Stem Cell Transplantation

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2555-2555
Author(s):  
Yao Yao ◽  
Xiaoli Li ◽  
Liangjing Xu ◽  
Bin Liu ◽  
Yue Han ◽  
...  
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Infection Rate ◽  
Cmv Infection ◽  
Hematopoietic Stem ◽  
Platelet Recovery ◽  
Matched Sibling

Abstract Objective To expolore the association of KIR2DS4 and its variant KIR1D with cytomegalovirus(CMV) infection after HLA-matched sibling hematopoietic stem cell transplantation. Methods Polymerase chain reaction with sequence-specific primers (PCR-SSP) method was used to genotype KIR genes in 267 donor-recipient pairs from Oct 2005 to Apr 2014. Posttransplant monitoring for CMV infection was performed by immune histochemically assays .165 donor-recipient pairs who belong to KIR gene haplotype AA were analyzed for the presence of KIR2DS4 and its variant KIR1D and then further subdivided into the following groups: 2DS4-/1D+ (homozygous for the deletion variant KIR1D), 2DS4+/1D+ (heterozygous), 2DS4+/1D- (two intact KIR2DS4 alleles). Furthermore, we investigated the influence of the KIR2DS4 variants on CMV infection of 165 patients receiving Sibling related HLA matched transplantation. Results There were no significant differences in frequency of KIR2DS4 or KIR1D between donors and recipients in the haplotype AA group. The ratio of 2DS4+ and KIR1D in haplotype AA group was 2:1.There was no difference on neutrophil engraftment and platelet recovery among the three groups after hematopoietic stem cell transplantation. The CMV infection rate was significantly higher in 2DS4+/1D- group compared with 2DS4+/1D+ group (44.0% vs 19.0%，P=0.002)．In 2DS4-/1D+ group ，the CMV infection rate was higer than that in 2DS4+KIR1D+ group (50.0% vs 19%，P=0.028). However，there was no difference in CMV infection rate between 2DS4+/1D-group and 2DS4-/1D+ group. Conclusion KIR2DS4 and its variant KIR1D are associated with CMV infection after HLA-matched sibling hematopoietic stem cell transplantation Disclosures No relevant conflicts of interest to declare.

scholarly journals HEMATOPOIETIC STEM CELL TRANSPLANTATION FOR PEDIATRIC LYMPHOMAS

JBMTCT ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 135
Author(s):  
Cilmara Cristina Kuwahara ◽  
Gabriele Zamperlini Neto ◽  
Mariana Bohns Michalowski ◽  
Valéria Cortez Ginani ◽  
Carla Nolasco Monteiro Breviglieri
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Salvage Treatment ◽  
Hematopoietic Stem ◽  
The Third ◽  
The Past ◽  
Common Cancer

Lymphomas are the third most common cancer of childhood in Brazil. Over the past few decades, the prognosis has significantly improved, however relapsed or refractory disease is still associated with an inferior outcome. Hematopoietic stem cell transplantation (HSCT) is the standard salvage treatment strategy for these patients. A review was made using the most relevant articles and discussion between the authors was done for guide the recomendations exposed here.

An Experimental and Clinical Study of CMV Infection after Allogeneic Hematopoietic Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5084-5084
Author(s):  
De Pei Wu ◽  
Xiaojin Wu ◽  
Caixia Li ◽  
Xiao Ma ◽  
Aining Sun
Keyword(s):  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Infection Rate ◽  
Nested Pcr ◽  
Cmv Infection ◽  
Pcr Assay ◽  
Hematopoietic Stem

Abstract Objective: To establish quick and reliable diagnostic methods for detecting the cytomegavirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to evaluate their clinical value in early diagnosis of CMV infection Methods: (1) From March 2001 to December 2003, Seventy-four patients undergoing allo-HSCT were enrolled in this study. After allo-HSCT, all the patients were detected for CMV gB DNA in peripheral blood by haplo-nested PCR methods and 35 of 74 patients for CMV PP65 antigen in peripheral blood by the fluorescent immunohistochemistry (FIHT) assay. The positive rate and correspondence of these two methods were evaluated. Results: (1) In 35 of 74 patients who were tested for CMV infection by two assays at the same time, the CMV-viremia was first detected at a median of 36 days after transplantation by FIHT assay and 26 days by haplo-nested PCR assay during the follow-up time of 90~720 days. The median time of positive persistence was 19 days by FIHT assay and 28 days by haplo-nested PCR assay. The significant difference of them was observed (P<0.05). The corresponding of the two assays was 88.57%. The difference of the two methods was not significant statistically. The incidence of CMV-agtigenemia and CMV-DNAemia were 65.71% and 71.43% during the follow-up days, respectively. (2) The infection rate in the nonmyeloablative allogeneic peripheral stem cell transplantation (NST) group was 78.95%, in the group of related peripheral blood stem cell transplantation (R-PBSCT) and/or related bone marrow transplantation (R-BMT) 48.57%, and in the group of unrelated bone marrow transplantation (UR-BMT) 61.54%. The infection rate of CMV in the UR-BMT group was higher than that in R-PBSCT and/or R-BMT group, but without significant difference (P>0.05). The infection rate of CMV in the NST group was significantly higher than in R-PBSCT and/or R-BMT group (P<0.05), but only a litter higher than in UR-BMT group (P>0.05). Both CMV-antigen and CMV-DNA were detected in all seven patients undergoing haploidentical hematopoietic stem cell transplantation (Hi-HSCT). Conclusion: (1) Both FIHT and haplo-nested PCR assays were quick and reliable diagnostic methods for detecting the CMV infection after allo-HSCT and their correspondence was good. However CMV infection could be found earlier by haplo-nested PCR assay than by FIHT assay. (2) The infection rate of CMV is high after allo-HSCT and might be different in different types of allo-HSCT.

Minoriting Cvtomegalovirus after Hematopoietic Stem Cell Transplantation for Seven Years-a Single Center Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4376-4376
Author(s):  
Xiaojin Wu ◽  
Wu Depei ◽  
Aining Sun ◽  
Xiaowen Tang ◽  
Zhengzheng Fu ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Stem Cell ◽  
Hematopoietic Stem Cell Transplantation ◽  
Stem Cell Transplantation ◽  
Antiviral Therapy ◽  
Cell Transplantation ◽  
Hematopoietic Stem Cell ◽  
Cmv Infection ◽  
Hematopoietic Stem ◽  
Significant Difference

Abstract Objective: To investigate the incidence, risk factor and management of CMV reactivation in patients revived hematopoietic stem cell transplantation(HSCT). Methods: 374 patients including 275 consecutive allogeneic and 99 autologous patients after bone marrow/stem cell transplantation from May 2001 to December 2007 were studied at our institution with nest-PCR and pp65 antigen assay. Anticoagulant blood samples were obtained from the recipients once weekly after days 14. After three months the CMV monitoring was performed every one month or every three months. If the patients catch CMV again after three year, the CMV monitoring was performed again. Results: The incidence of CMV positive in autologous patients was 3.03% and was 54.91% in allogeneic patients with a median onset of 48 days post transplants during 1 to 81 months. The difference between them is significant; The infection rate in the nonmyeloablative allogeneic peripheral stem cell transplantation (NST) group was 61.76%, in the group of HLA—identical sibling donor HSCT(sib-HSCT) was 47.10%, in haploidentical hematopoietic stem cell transplantation (Hi-HSCT) group was 75.00% and in the group of unrelated bone marrow transplantation (UR-BMT) was 57.45%. The infection rate of CMV in the Hi-HSCT group was higher than that in the group of sib-HSCT with significant difference (P&lt;0.05); The incidence rate of CMV infection in patients with regimen including ATG was higher than that without ATG ((65%&47.1%, P&lt;0.05); The incidence rate of CMV infection in patients with III–IV grade aGVHD and patients without III–IV aGVHD had not significant difference (P&gt;0.05). There was not significant difference in the occurance of aGVHD between the patients with and without CMV infection (P&gt;0.05).5.87.8% patients are effective on antiviral therapy, incidence of CMV disease is very low, 0.65% patients catch CMV more than once. Conclusion FCMV infection is common in our study, Minoriting CMV for long time is necessary, which benefit to antiviral therapy and judging of prognosis.

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