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首页> 外文期刊>Hematology/Oncology and Stem Cell Therapy >Evaluation of cytomegalovirus reactivation and tolerability in seropositive umbilical cord transplant patients after implementation of an intensive prevention strategy
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Evaluation of cytomegalovirus reactivation and tolerability in seropositive umbilical cord transplant patients after implementation of an intensive prevention strategy

机译：实施强化预防策略后，对血清阳性的脐带移植患者的巨细胞病毒活化和耐受性的评估

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Objective/Background: Cytomegalovirus (CMV) causes significant morbidity and mortality in CMV seropositive patients undergoing umbilical cord blood transplants (UCBT). Our study aimed to describe the incidence of CMV reactivation and burden of disease, as well as the tolerability of an intensive prevention strategy as compared to historical prevention. Methods: This was a retrospective chart review of 33 CMV seropositive patients that underwent UCBT. The intensive prevention strategy in UCBT consisted of ganciclovir 5mg/kg/d intravenously or valganciclovir 900mg by mouth daily initiated at the beginning of the conditioning regimen until Day -2. Then from Day -1 to Day +100, patients received valacyclovir 2g by mouth three times daily, and from Day +101 to Day +365, acyclovir 800mg by mouth twice daily. Historical standard prevention was acyclovir 800mg by mouth twice daily initiated at the beginning of the conditioning regimen until Day +365. Results: Thirty-three patients were included from 2008 to 2014. There were no differences in the adverse effects experienced between the two regimens (p=.4). CMV reactivation occurred significantly later with intensive prevention (p=.003). The median CMV viral titer at reactivation was lower in the intensive versus the historic prevention (1,800copies/mL and 2,700copies/mL, respectively), but was not significantly different. CMV disease occurred significantly less often in the intensive group (p=.039). Conclusion: The results from this study indicate that the intensive prevention strategy was well tolerated, significantly delayed CMV reactivation, and patients had less CMV disease.
机译：目的/背景：巨细胞病毒（CMV）导致接受脐带血移植（UCBT）的CMV血清反应阳性患者的明显发病率和死亡率。我们的研究旨在描述CMV再激活的发生率和疾病负担，以及与历史预防相比，强化预防策略的耐受性。方法：这是对33例接受UCBT的CMV血清反应阳性患者的回顾性图表回顾。 UCBT中的强化预防策略包括在调整方案开始至第-2天时开始口服静脉注射更昔洛韦5mg / kg / d或口服每日口服更昔洛韦900mg。然后从第-1天到第+100天，患者每天口服3次valacyclovir 2g，从第101天到+365天，患者口服两次阿昔洛韦800mg。历史标准预防方法是在调理方案开始前每天口服两次口服阿昔洛韦800mg，直至+365天。结果：2008年至2014年共纳入33例患者。两种方案的不良反应无差异（p = .4）。在加强预防的情况下，CMV重新激活显着发生在以后（p = .003）。在强化治疗中，再激活时的CMV病毒滴度中值比历史性预防措施要低（分别为1,800拷贝/ mL和2,700拷贝/ mL），但无显着差异。在高强度人群中，CMV疾病的发生率明显降低（p = .039）。结论：这项研究的结果表明，强化预防策略耐受性良好，CMV重新激活明显延迟，并且患者的CMV疾病较少。

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