Title: | Regimen-Related Mucosal Injury of the Gut Increased the Incidence of CMV Disease after Allogeneic Bone Marrow Transplantation |
Authors: | Shigematsu, Akio Browse this author |
Yasumoto, Atsushi Browse this author |
Yamamoto, Satoshi Browse this author |
Sugita, Junichi Browse this author |
Kondo, Takeshi Browse this author →KAKEN DB |
Onozawa, Masahiro Browse this author |
Kahata, Kaoru Browse this author |
Endo, Tomoyuki Browse this author |
Ota, Shuichi Browse this author |
Sato, Norihiro Browse this author |
Takahata, Mutsumi Browse this author |
Okada, Kohei Browse this author |
Tanaka, Junji Browse this author →KAKEN DB |
Hashino, Satoshi Browse this author |
Nishio, Mitsufumi Browse this author |
Koike, Takao Browse this author |
Asaka, Masahiro Browse this author |
Imamura, Masahiro Browse this author |
Keywords: | Reduced-intensity conditioning |
Bone marrow transplantation |
Cytomegalovirus infection |
Mucosal injury |
Graft-versus-host disease |
Issue Date: | Jun-2009 |
Publisher: | Elsevier Inc. |
Journal Title: | Biology of Blood and Marrow Transplantation |
Volume: | 15 |
Issue: | 6 |
Start Page: | 679 |
End Page: | 685 |
Publisher DOI: | 10.1016/j.bbmt.2009.02.006 |
PMID: | 19450752 |
Abstract: | Cytomegalovirus (CMV) infection is one of the major causes of morbidity in patients undergoing allogeneic stem cell transplantation (alloSCT). The incidences of CMV antigenemia and CMV disease in 43 patients who received allogeneic bone marrow transplantation (BMT) using a reduced-intensity conditioning (RIC) regimen, which mainly consisted of fluclarabine, busulfan and total body irradiation, were compared with those in 68 patients who received a myeloablative conditioning (MAC) regimen, and risk factors for CMV antigenemia and CMV disease were identified. Before engraftment, grade 3-4 mucosal injury due to the conditioning regimen was significantly decreased in RIC patients (stomatitis: P = 0.02; diarrhea: P < 0.01). Rate of engraftment, incidences of acute graft-versus-host disease (aGVHD) and rate of corticosteroid administration were not different in RIC patients and MAC patients. Although the incidences of CMV antigenemia were not significantly different in RIC patients and MAC patients (64.1% vs. 57.8%, logrank, P = 0.59), the incidence of CMV disease was significantly decreased in RIC patients (5.4% vs. 20.3%, logrank, P = 0.04). CMV seropositivity in the patients (P < 0.01) and corticosteroid administration (P < 0.01) were revealed by multivariate analysis to be significant risk factors for CMV antigenemia. Grade II-IV aGVHD (P = 0.02) and grade 3-4 diarrhea before engraftment (P = 0.04) were revealed to be risk factors for CMV disease. The present study is the first study to show that severe diarrhea before engraftment is a significant risk factor for CMV disease. In summary, risk of CMV disease was significantly decreased in patients without severe mucosal injury of the gut due to the conditioning regimen before engraftment. |
Type: | article (author version) |
URI: | http://hdl.handle.net/2115/38731 |
Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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