Document Detail


Increased incidence of cytomegalovirus disease after autologous CD34-selected peripheral blood stem cell transplantation.
MedLine Citation:
PMID:  10590046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High-dose therapy with autologous peripheral blood stem cell (PBSC) rescue is widely used for the treatment of malignant disease. CD34 selection of PBSC has been applied as a means of reducing contamination of the graft. Although CD34 selection results in a 2 to 3 log reduction in contaminating tumor cells without significantly delaying engraftment, many other types of cells are depleted from the CD34-enriched grafts and immune reconstitution may be impaired. In the present study, 31 cytomegalovirus (CMV)-seropositive patients who received myeloablative therapy followed by the infusion of CD34-selected autologous PBSC were assessed for the development of CMV disease in the first 100 days posttransplant. Seven patients (22.6%) developed CMV disease and 4 patients (12.9%) died from complications of their infection. In a contemporaneous group of 237 CMV-seropositive patients receiving unselected, autologous PBSC, only 10 patients (4.2%) developed CMV disease, with 5 deaths (2.1%). In a multivariate logistic regression analysis, the use of CD34-selected autologous PBSC after high-dose therapy was associated with a marked increase in the incidence of CMV disease and CMV-associated deaths.
Authors:
L A Holmberg; M Boeckh; H Hooper; W Leisenring; S Rowley; S Heimfeld; O Press; D G Maloney; P McSweeney; L Corey; R T Maziarz; F R Appelbaum; W Bensinger
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Blood     Volume:  94     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-01-10     Completed Date:  2000-01-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  4029-35     Citation Subset:  AIM; IM    
Affiliation:
Clinical Division, Fred Hutchinson Cancer Research Center, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antigens, CD34
Autoimmune Diseases / therapy*
Child
Child, Preschool
Cytomegalovirus / isolation & purification*
Cytomegalovirus Infections / etiology*
Female
Graft Survival
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Male
Middle Aged
Neoplasms / therapy*
Transplantation, Autologous / adverse effects
Grant Support
ID/Acronym/Agency:
CA18029/CA/NCI NIH HHS; CA18221/CA/NCI NIH HHS; CA47748/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antigens, CD34
Comments/Corrections
Comment In:
Blood. 2001 Apr 1;97(7):2183-5   [PMID:  11286223 ]
Blood. 2000 Aug 1;96(3):1194   [PMID:  10960239 ]
Blood. 2000 Jun 15;95(12):4016-8   [PMID:  10939798 ]
Blood. 2000 Jul 1;96(1):369-70   [PMID:  10939802 ]

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


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