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Related Collections Neoplasia Transplantation Clinical Trials and Observations Related Letter in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 June 2002, Vol. 99, No. 12, pp. 4357-4363 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS High incidence of cytomegalovirus infection after nonmyeloablative stem cell transplantation: potential role of Campath-1H in delaying immune reconstitution Suparno Chakrabarti, Stephen Mackinnon, Raj Chopra, Panagiotis D. Kottaridis, Karl Peggs, Peter O'Gorman, Ronjon Chakraverty, Timothy Marshall, Husam Osman, Premini Mahendra, Charles Craddock, Herman Waldmann, Geoff Hale, Christopher D. Fegan, Kwee Yong, Anthony H. Goldstone, David C. Linch, and Donald W. Milligan From the Departments of Haematology and Public Health Laboratories, Birmingham Heartlands Hospital, Department of Public Health and Epidemiology, Institute of Cancer Studies, University of Birmingham, Birmingham, United Kingdom; Department of Haematology, University College Hospital, London, United Kingdom; Department of Haematology, Christie Hospital, Manchester University Hospital, Birmingham, United Kingdom; and Sir William Dunn School of Pathology, Oxford, United Kingdom. Nonmyeloablative conditioning is increasingly used for transplantation in a wide range of diseases, but little is known about its impact on the incidence of infections and immune reconstitution. We examined the pattern and outcome of cytomegalovirus (CMV) infections monitored by polymerase chain reaction-based assays and treated preemptively in 101 patients following nonmyeloablative conditioning containing in vivo Campath-1H. Fifty-one patients (50%) had a CMV infection at a median of 27 days after transplantation with a probability of 84.8% in patients at risk of CMV infection. The probability of recurrence of CMV infection before and after 100 days was 53.6% and 46.6%, respectively, and was more common in unrelated donor transplant recipients. All 3 patients who developed CMV disease died of this complication. The 2 patients with late CMV disease had grade III to IV graft-versus-host-disease (GVHD), which occurred de novo in only 4% of patients and in another 10% following donor lymphocyte infusions. The median time to CD4+ T-cell count more than 200/µL was 9 months in the 48 patients studied. The probabilities of overall survival and nonrelapse mortality at 18 months were 65% and 27.8%, respectively, with no significant difference in survival between CMV-infected and -uninfected patients. The use of Campath-1H appeared to be associated with a low incidence of GVHD but a high incidence of CMV infections and prolonged immune paresis. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Letter in Blood Online: CMV infection following nonmyeloablative allogeneic stem cell transplantation using Campath Rowena D. Bainton, Jennifer L. Byrne, Barbara J. Davy, and Nigel H. Russell Blood 2002 100: 3843. [Full Text] [PDF] This article has been cited by other articles: A. M. Leen, A. Christin, G. D. Myers, H. Liu, C. R. Cruz, P. J. Hanley, A. A. Kennedy-Nasser, K. S. Leung, A. P. Gee, R. A. Krance, et al. Cytotoxic T lymphocyte therapy with donor T cells prevents and treats adenovirus and Epstein-Barr virus infections after haploidentical and matched unrelated stem cell transplantation Blood, November 5, 2009; 114(19): 4283 - 4292. [Abstract] [Full Text] [PDF] W. Zhou, J. Longmate, S. F. 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