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      Cytomegalovirus infection after allogeneic stem cell transplant in children.

      1 , , ,
      Pediatric transplantation
      Wiley

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          Abstract

          The aim of this study was to examine the frequency and the course of cytomegalovirus (CMV) infection and CMV disease in a group of pediatric and adolescent patients after allogeneic stem cell transplantation. Patients were treated according to a protocol including prophylactic high-dose acyclovir in combination with preemptive administration of ganciclovir, based on weekly examinations of CMV antigenemia. A total of 110 consecutively transplanted patients, with a mean age of 9 yr (range 0-20) were treated according to the protocol. All patients were transplanted between March 1993 and January 2000 at the only Danish allotransplantation center. CMV infection occurred in 21.8% (24 of 110) of the patients. Three patients [12.5% (3/24)] developed CMV disease, all with pneumonitis and one with gastrointestinal disease as well. Mean time of disease onset was day +58. Treatment with ganciclovir was in general well tolerated. Late onset CMV disease was not documented. Multivariate analysis revealed that the use of unrelated donor transplants was significantly associated with an increased risk for CMV infection [hazard ratio (HR) 2.90, p = 0.03] and CMV infection was found to be a risk factor for transplant related mortality before day +100 (HR 10.70, p = 0.0015). Although high-dose acyclovir in combination with antigenemia based preemptive treatment with ganciclovir resulted in a low incidence of CMV disease in pediatric and adolescent patients, CMV infection was a significant risk factor in stem cell transplantation with unrelated donors.

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          Author and article information

          Journal
          Pediatr Transplant
          Pediatric transplantation
          Wiley
          1397-3142
          1397-3142
          Dec 2005
          : 9
          : 6
          Affiliations
          [1 ] Pediatric Clinic II 4064, The Juliane Marie Centre, The University Hospital, Rigshospitalet, Denmark. rh13966@rh.dk
          Article
          PTR370
          10.1111/j.1399-3046.2005.00370.x
          16269044
          e1c623d4-5180-4932-a59c-3cd0cf35f725
          History

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