Document Detail


Human herpesvirus 6 infection after hematopoietic cell transplantation: is routine surveillance necessary?
MedLine Citation:
PMID:  21549850     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Human herpesvirus 6 (HHV6) may be an important pathogen following allogeneic hematopoietic cell transplantation (HCT). We prospectively evaluated weekly HHV6 viremia testing after allogeneic HCT using a quantitative polymerase chain reaction (PCR)-based assay. HHV-6 viremia was detected in 46 of 82 (56%) patients at a median of 23 days post-HCT (range: day +10 to +168). More males (65% vs females 39%, P = .03) and recipients of umbilical cord blood (UCB 69% vs unrelated donor [URD], 46% vs sibling donor [20%] grafts, P = 0.01) reactivated HHV-6. Patients with HHV6 viremia had more cytomegalovirus (CMV) reactivation (26% vs 5.5%, P = .01) and unexplained fever and rash (23.9% vs 2.7%, P = .01) compared with patients without HHV6 viremia. High-level HHV6 (≥ 25,000 copies/mL) versus lower levels were associated with more culture-negative pneumonitis (72.7% vs 22.8%, P = .01). Twenty HHV6-positive patients were treated with foscarnet, ganciclovir, or cidofovir for HHV6 or other coexistent viruses. Within 2 weeks, HHV6 viremia resolved more commonly in treated (65%) than untreated patients (31%), P = .02. Survival at 3 months was similar in treated and untreated patients (90% vs 81%, P = .4). Survival at 3 and 6 months post-HCT were not affected by HHV6 positivity (3 months HHV6+ 85% vs 78%, P = .46; 6 months HHV6+ 70% vs 72%, P = .89) or by HHV6 level (3-month high level 73% vs 89%, P = .23; 6-month high level 64% vs 71%, P = .54). Neither the occurrence of HHV6, degree of viremia, nor use of antiviral drugs influenced short-term survival after HCT.
Authors:
Brian C Betts; Jo-Anne H Young; Celalettin Ustun; Qing Cao; Daniel J Weisdorf
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2011-04-20
Journal Detail:
Title:  Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation     Volume:  17     ISSN:  1523-6536     ISO Abbreviation:  Biol. Blood Marrow Transplant.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-09-19     Completed Date:  2012-02-20     Revised Date:  2014-04-21    
Medline Journal Info:
Nlm Unique ID:  9600628     Medline TA:  Biol Blood Marrow Transplant     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1562-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antiviral Agents / administration & dosage
Child
Child, Preschool
Cytomegalovirus Infections / drug therapy,  etiology,  mortality
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation*
Herpesvirus 6, Human*
Humans
Infant
Male
Middle Aged
Prospective Studies
Roseolovirus Infections / blood,  drug therapy,  etiology,  mortality*
Sex Factors
Siblings
Survival Rate
Transplantation, Homologous
Unrelated Donors
Viremia / drug therapy,  mortality
Grant Support
ID/Acronym/Agency:
T32 CA009207/CA/NCI NIH HHS; T32 CA009207-35/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antiviral Agents
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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