Cytomegalovirus pneumonia prior to engraftment following T-cell depleted bone marrow transplantation
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CMV pneumonia is a frequent complication of allogeneic bone marrow transplantation (BMT). It usually appears 23 months following transplantation and is associated with a high mortality rate. The incidence of CMV pneumonia in our T-lymphocyte depleted allogeneic BMT recipients, transplanted between 1987–1991, was 18 out of 197 (9.2%) patients. In 3 patients (1.5% of allogeneic BMT recipients), pneumonia occurred prior to marrow engraftment, on days 12–16 post BMT. These patients did not develop acute GVHD in contrast to 9/11 patients who had acute GVHD in addition to developing CMV pneumonia between engraftment and day +100 (p<0.03). Furthermore, these three patients did not receive steroid therapy as opposed to 14/15 patients who were treated with steroids and eventually contracted CMV pneumonia post-engraftment (p<0.01). The three patients did not have two additional risk factors known for the development of CMV pneumonia: increasing age and a diagnosis of acute myeloblastic leukemia (AML) as the primary disease. Despite prompt diagnosis and therapy with ganciclovir and high doses of intravenous immunoglobulin (IVIG), two of the patients died. Tcell depleted BMT may be a risk factor for development of CMV pneumonia occurring prior to engraftment. In the era of post-BMT anti CMV prophylaxis, one should be aware that life-threatening CMV pneumonia may appear prior to engraftment and consider aggressive CMV prophylaxis.
- Meyers JD, Flournoy N, Thomas ED. Risk factors for cytomegalovirus infection after bone marrow transplantation.J lnfect Dis,153, 478–482 (1986).
- Engelhard D, Or R, Strauss N etal. Cytomegalovirus infection and disease after Tcell depleted allogeneic bone marrow transplantation for malignant hematological diseases.Transplant Proc,21, 3101–3102 (1989).
- Engelhard D, Marks MI, Good RA. Infection in bone marrow transplant recipients.J Pediat,108, 335–346 (1986). CrossRef
- Sullivan KM, Meyers JD, FIournoy N, Storb R, Thomas ED: Early and [ate interstitial pneumonia following human bone marrow transplantation.Int J Cell Clon,4, 107–112 (1986). CrossRef
- Guyotat O, Gibert R, Chomel J etal. Incidence and prognosis of cytomegalovirus infections following allogeneic bone marrow transplantation.J Med Virol,23, 393–399 (1987). CrossRef
- Ljungman P, Engelhard D, Link Het al. Cytomegalovirus interstitial pneumonitis: treatment with ganciclovir and intravenous immune globulin. European Bone Marrow Transplant Group Experience.Clin Infect Diseases,14, 831–835 (1992).
- Meyers JD, Reed E, Shepp Det al. Acyclovir for prevention of CMV infection and disease after allogeneic marrow transplantation.N Engl Med,318, 70–75 (1988).
- Atkinson K, Downs K, Golenia M etal. Prophylactic use of ganciclovir in allogeneic bone marrow transplantation: absence of clinical cytomegalovirus infection.Brit J Haematol,79, 57–62 (1991). CrossRef
- Goodrich JM, Bowden RA, Fisher L, Keller C, Schoch G, Meyers JD. Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant.Ann Intern Med,118, 173–178 (1993).
- Reusser P, Gambertoglio J, Lilleby K, Meyers JD. Phase III trial of foscarnet for prevention of cytomegalovirus infection in autologous and allogeneic marrow transplant recipients.J Infect Dis,166. 473–479 (1992).
- Goodrich JM, Mori M, Gleaves CAet al. Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplantation.N Engl J Med,325, 1601–1607 (1991).
- Schmidt GM, Horak.DA, Niland JC, Duncan SR, Forman SJ, Zaia JA.. A randomised, controlled trial of prophylactic ganciclovir for cytomegalovirus pulmonary infection in recipients of allogeneic bone marrow transplants.N Eng J Med,324, 1005–11 (1991). CrossRef
- Milpied N, Harousseau JL, Moreau P, Lacroix F, Ramee JF, Billaudel S. DHPG at CMV viremia after allogeneic bone marrow transplantation. Result over a four year period (1986-1990).Bone Marrow Transplant,7 (Suppl 2), 46 (1991).
- Ljungman P, de Bock R, Cordonnier Cet al. Practices for cytomega!ovirus diagnosis, prophylaxis, and treatment in allogeneic bone marrow transplant recipients: a report from the Working Party for Infectious Diseases within the EBMT. Bone Marrow Transplantation.Bone Marrow Transplant,12, 399–403 (1993).
- Waldmann H, Polliack A, Hale Get al. Elimination of graft versus host disease byin vitro depletion of alloreactive lymphocytes with a monoclonal rat anti-human lymphocyte antibody (CAMPATH).Lancet ii, 483485 (1984).
- Engelhard D, Morag A, Naparstek Eet al. Prevention of herpes simplex virus infection in recipients of HLA-matched T-lymphocyte depleted bone marrow allografts.Is J Med Sci,24 (3), 145–150 (1988).
- Biron CA, Byron KS, Sullivan JL. Severe herpesvirus infections in an adolescent without natural killer cells.N Engl J Med,320, 1731- 1735 (1989).
- Reusser P, Riddell SR, Meyers JD, Greenberg PD. Cytotoxic T lymphocyte response to cytomegalovirus after human allogeneic bone marrow transplantation: pattern of recovery and correlation with cytomegalovirus infection and disease.Blood,78, 1373–1380 (1991).
- Reddehase MJ, Weiland F, Munch K, Jonjic S, Luske A, Koszinowski, UH. Interstitial routine cytomegalovirus pneumonia after irradiation: Characterisation of cells that limit viral replication during established infections of the lungs.J Virol,55, 264–273 (1985).
- Riddell SR Watanabe KS, Goodrich JM, Li CR, Agha ME, Greenberg PD. Restoration of viral immunity in immunodeficient humans by the adoptive transfer of clones.Science,257, 238–241 (1992). CrossRef
- Henter JI, Elinder G, Ost A. FHL Study Group of the Histocyte Society. Diagnostic guidelines for hemophagocytic lymphohistiocytosis.Semin Oncol,18, 29–33. (1991)
- Emanuel D, Cunningham I, JulesElysee Ket al. Cytomegalovirus pneumonia after bone marrow transplantation successfully treated with the combination of ganciclovir and high dose intravenous immune globulin.Ann Intern Med,109, 777–782 (1988).
- Reed EC, Bowden RA, Dandliker PS, Lilleby KE, Meyers JD. Treatment of cytomegalovirus pneumonia with ganciclovir and intravenous cytomegalovirus immunoglobulin in patients with bone marrow transplants.Ann Intern Med,109, 783–788 (1988).
- Cytomegalovirus pneumonia prior to engraftment following T-cell depleted bone marrow transplantation
Volume 11, Issue 3-4 , pp 127-132
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- CMV disease
- intravenous immune globulin
- bone marrow transplantation
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- Author Affiliations
- 1. Departments of Bone Marrow Transplantation, Hadassah University Hospital, 91120, Jerusalem, Israel
- 2. Departments of Pediatrics, Hadassah University Hospital, 91120, Jerusalem, Israel
- 3. Departments of Pulmonology, Hadassah University Hospital, 91120, Jerusalem, Israel