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Prepublished online as a Blood First Edition Paper on May 13, 2002; DOI 10.1182/blood-2002-02-0377. This Article Full Text (PDF) All Versions of this Article: 2002-02-0377v1 100/5/1619    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Chakrabarti, S. Articles by Milligan, D. W Search for Related Content PubMed PubMed Citation Articles by Chakrabarti, S. Articles by Milligan, D. W Social Bookmarking                   What's this? Submitted February 5, 2002 Accepted April 22, 2002 Adenovirus infections following allogeneic stem cell transplantation: the incidence and outcome in relation to graft manipulation, immunosuppression and immune recovery Suparno Chakrabarti*, Vivien Mautner, Husam Osman, Kathryn E Collingham, Christopher D Fegan, Paul E Klapper, Paul A Moss, and Donald W Milligan Haematology and Virology, Birmingham Heartlands Hospital, Birmingham, United Kingdom; CRC Institute for Cancer Studies, University of Birmingham, Birmingham, United Kingdom CRC Institute for Cancer Studies, University of Birmingham, Birmingham, United Kingdom Haematology and Virology, Birmingham Heartlands Hospital, Birmingham, United Kingdom Clinical Virology, Manchester Royal Infirmary, Manchester, United Kingdom * Corresponding author; email: suparno{at}doctors.org.uk. Adenovirus infections occur in 5- 21% of patients following stem cell transplantation (SCT) with an associated mortality of upto 50%. However, a lack of prospective studies has hampered further developments in the understanding and management of this infection in the post-transplant setting. We prospectively studied the incidence and outcome of adenovirus infection after SCT using pre-emptive screening and a policy of reduction or withdrawal of immunosuppressive therapy if the virus was isolated. The incidence of adenovirus infection was 19.7% (15/76) and the virus was isolated exclusively in recipients of T cell depleted grafts. Patients receiving 50 or 100 mg Campath in-vivo were at the greatest risk of adenovirus infection (45% probability) irrespective of donor-type and this was related to the slower lymphocyte recovery. Six (40%) of the 15 adenovirus infected patients developed adenovirus disease. Severe lymphocytopenia (< 300/mm3) at the time of first detection of adenovirus was a major risk factor for development of adenovirus disease (p=0.001). In addition, failure to reduce immunosuppression (p=0.04) and a positive adenovirus PCR on blood at diagnosis (p=0.01) were both associated with fatal adenovirus disease. Based on this study, we recommend active surveillance for adenovirus infection in T cell depleted SCT and withdrawal or reduction of immunosuppressive treatment if possible, in patients with adenovirus infection. Pre-emptive antiviral therapy is warranted for patients with severe lymphocytopenia, positive blood PCR and in those in whom immunosuppressive therapy cannot be reduced. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? 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. 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