Regimen-Related Mucosal Injury of the Gut Increased the Incidence of CMV Disease after Allogeneic Bone Marrow Transplantation

Shigematsu, Akio; Yasumoto, Atsushi; Yamamoto, Satoshi; Sugita, Junichi; Kondo, Takeshi; Onozawa, Masahiro; Kahata, Kaoru; Endo, Tomoyuki; Ota, Shuichi; Sato, Norihiro; Takahata, Mutsumi; Okada, Kohei; Tanaka, Junji; Hashino, Satoshi; Nishio, Mitsufumi; Koike, Takao; Asaka, Masahiro; Imamura, Masahiro

Regimen-Related Mucosal Injury of the Gut Increased the Incidence of CMV Disease after Allogeneic Bone Marrow Transplantation

Shigematsu, Akio; Yasumoto, Atsushi; Yamamoto, Satoshi et al.

Biology of Blood and Marrow Transplantation, 2009, 15(6), 679-685

Permalink : https://hdl.handle.net/2115/38731

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アクセス権	open access
URI	https://hdl.handle.net/2115/38731
タイトル	Regimen-Related Mucosal Injury of the Gut Increased the Incidence of CMV Disease after Allogeneic Bone Marrow Transplantation
著者	Shigematsu, Akio ; Yasumoto, Atsushi ; Yamamoto, Satoshi ; Sugita, Junichi ; Kondo, Takeshi ; Onozawa, Masahiro ; Kahata, Kaoru ; Endo, Tomoyuki ; Ota, Shuichi ; Sato, Norihiro ; Takahata, Mutsumi ; Okada, Kohei ; Tanaka, Junji ; Hashino, Satoshi ; Nishio, Mitsufumi ; Koike, Takao ; Asaka, Masahiro ; Imamura, Masahiro
著者名 Shigematsu, Akio
著者名 Yasumoto, Atsushi
著者名 Yamamoto, Satoshi
著者名 Sugita, Junichi
e-Rad_Researcher 70333606 著者名 Kondo, Takeshi
著者名 Onozawa, Masahiro
著者名 Kahata, Kaoru
著者名 Endo, Tomoyuki
著者名 Ota, Shuichi
著者名 Sato, Norihiro
著者名 Takahata, Mutsumi
著者名 Okada, Kohei
e-Rad_Researcher 50250452 著者名 Tanaka, Junji
著者名 Hashino, Satoshi
著者名 Nishio, Mitsufumi
著者名 Koike, Takao
著者名 Asaka, Masahiro
著者名 Imamura, Masahiro
言語	英語
キーワード	Reduced-intensity conditioning
	Bone marrow transplantation
	Cytomegalovirus infection
	Mucosal injury
	Graft-versus-host disease
発行日	2009-06
出版者	Elsevier Inc.
収録物名	Biology of Blood and Marrow Transplantation
巻(号)	15(6)
ページ	679-685
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	1083-8791
関連情報	PMID 19450752
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.bbmt.2009.02.006