Cytomegaloviral infection in patients with hemoblastoses

Abstract


Aim. To estimate the incidence of cytomegaloviral (CMV) infection and CMV disease in patients with
acute leukemia at different stages of chemotherapy and in patients after transplantation of hemopoietic
cells.
Material and methods. The trial was carried out in 33 patients with acute leukemia at different stages
of chemotherapy, 20 patients subjected to transplantation of autologic hemopoietic cells and 21 patients
who had received transplantation of allogenic hemopoietic cells. To study the dynamics of the
CMV infection markers, enzyme immunoassay of the titer of the specific immunoglobulins M and G
was made, detection of the viral antigen in immunofluorescence reaction and cultivation with fibroblast
cell culture and determination of the cytomegalovirus DNA by polymerase chain reaction (PCR).
Results. Before chemotherapy, up to 90% patients with acute leukemia were infected with cytomegalovirus
(similar rate of infection was observed in healthy donors of hemopoietic cells). By the time of
transplantation all the patients were infected with cytomegalovirus. During chemotherapy of acute
leukemia, the primary infection and reactivation of latent infection occurred in 30% patients, whereas
CMV disease developed in 18% patients. In case of transplantation of autologic hemopoietic cells the
rate of reactivation of CMV infection (15%) was one-half of that value in patients with acute leukemia
(30%). Similar trend was observed in case of development of CMV disease (5% and 18%, respectively).
In case of transplantation of allogenic hemopoietic cells the incidence of reactivation of CMV infection
was three times higher than in case of transplantation of autologic hemopoietic cells (47.6%
and 15%, respectively, p = 0.02). The incidence of development of CMV disease in case of transplantation
of allogenic hemopoietic cells was also significantly higher than in case of transplantation of autologic
hemopoietic cells (28.6% and 5%, respectively, p - 0.05).
Conclusion. Cytomegalovirus is an infection agent responsible for severe complications of chemotherapy
of acute leukemia and transplantation of hemopoietic cells in patients with hemoblastoses. Among
hematological patients, the group of the highest risk of development of this complication includes recipients
of transplantation of allogenic hemopoietic cells, particularly from seronegative donors.

References

  1. Davoli E. H., Lipson S. M. et al. Curley evaluation of the PrimeCapture CMV DNA Detection PlateSystem for detection of cytomegalovirus in clinical specimens. J. Clin. Microbiol. 1999; 37 (8): 2587-2591.
  2. Qamruddin A. O., Oppenheim B. A., Guiver M. et al. Skreening for cytomegalovirus (CMV) infection in allogeneic bone marrow transplantation using a quantatative whole blood polimerase chain reaction (PCR) method: analysis of potential factors for CMV infection. Bone Marrow Transplant. 2001; 27: 301 - 306.
  3. Boeckh M., Boivin G. Quantitation of cytomegalovirus: methodologic aspects and clinical applications. Clin. Microbiol. Rev. 1998; 11 (3): 533-554.
  4. Monte P. D., Lazzarotto Т., Ripalti A., Landini M. P. Human cytomegalovirus infection: a complex diagnostic problem in which molecular biology has induced a rapid evolution. Intervirology 1996; 39 (3): 193-203.
  5. Thomas E. D., Blume K. G., Forman S. J., eds. Hematopoietic cell transplantation. 2-nd ed. - London. 1999. 560-583.
  6. Моисеев С. И., Нуйя М. Л., Чеботкевич В. Н. и др. Цитомегалловирусная инфекция в практике трансплантации костного мозга. Тер. арх. 2002; 7: 44-48.
  7. Griffiths P. D. Viral complications after transplantation, J. Antimicrob. Chemother. 1995; 36 (suppl. B): 91-106.
  8. Maciejewski J. P., St. Jeor S. С. Human cytomegalovirus infection of human hematopoietic progenitor cells. Leukemia and Lymphoma 1999; 33 (1-2): 1-13.
  9. Gerna G., Percivalle E., Baldanti F. et al. Diagnostic significance and clinical impact of quantitative assays for diagnosis of human cytomegalovirus infection/disease in immunocompromised patients. New Microbiol. 1998; 21 (3): 293-308.
  10. Ehrnst A. The clinical relevance of different laboratory tests in CMV diagnosis. Scand. J. Infect. Dis. 1996; 100 (suppl.): 64- 71.
  11. Meyers J. D., Ljungman P., Fisher L. D. Cytomegalovirus excretion as a predictor of cytomegalovirus disease after marrow transplantation: cytomegalovirus viremia. J. Infect. Dis. 1990; 162: 373-380.
  12. Nguyen Q., Champlin R., Giralt S. et al. Late cytomegalovirus pneumonia in adult allogeneic blood and marrow transplant recipients. Clin. Infect. Dis. 1999; 28 (3): 618-623.
  13. Mocarski E. S., Abenes G. В., Manning W. C., et al. Molecular genetic analysis of cytomegalovirus gene regulation in growth, persistance, and latency. Curr. Top. Microbiol. Immunol. 1990; 154: 47-74.
  14. Meyer J. D., Flournoy N., Thomas E. D. Risk factors for cytomegalovirus infection after human marrow transplantation. J. Infect. Dis. 1986; 153: 478-488.
  15. de Medeiros С. R., Moreira V. A., Pasquini R. Cytomegalovirus as a cause of very late interstitial pneumonia after bone marrow transplantation. Bone Marrow Transplant. 2000; 26 (4): 443-444.
  16. Gondo H., Harada M., Minematsu T. et al. Cytomegalovirus antigenemia in the differential diagnosis of pulmonary infiltrates after allogeneic bone marrow transplantation. Rinsho Ketsueki 1993; 34 (11): 1438-1444.
  17. Meyer J. D., Spencer H. C., Jr., Watts J. С. et al. Cytomegalovirus pneumonia after human marrow transplantation. Ann. Intern. Med. 1975; 82: 181-188.
  18. Галстян Г. М. Септический шок и острая дыхательная недостаточность в гематологической клинике: Автореф. дис. . д-ра мед. наук. М.; 2003.
  19. Ahn J. H., Lee J. H., Lee К. Н. et al. Successful treatment with ganciclovir for cytomegalovirus duodenitis following allogenic bone marrow transplantation. Korean J. Intern. Med. 1999; 14 (1): 91-94.
  20. Page M. J., Dreese J. C., Poritz L. S., Koltun W. A. Cytomegalovirus enteritis: a highly lethal condition requiring early detection and intervention. Dis. Colon Rect. 1998; 41 (5): 619- 623.
  21. Reed E. C., Wolford J. L., Kopecky K. J. et al. Ganciclovir for the treatment of cytomegalovirus gastroenteritis in bone marrow transplant patients. A randomized, placebo-controlled trial. Ann. Intern. Med.1990; 112 (7): 505-510.
  22. Moudgil A., Germain B. M., Nast С. С. et al. Uretritis and cholecystitis: two unusual manifestations of cytomegalovirus disease in renal transplant recipients. Transplantation 1997; 64 (7): 1071-1073.
  23. Stocchi R., Ward K. N., Fanin R. et al. Management of human cytomegalovirus infection and disease after allogeneic bone marrow transplantation. Haematologica 1999; 84 (1): 71-79.
  24. Масчан А. А. Поражения, вызываемые герпес-вирусами. В кн.: Волкова М. А. (ред.) Клиническая онкогематология. М.: Медицина; 2001; гл. 36: 529-538.
  25. Florena A. M., Iannitto E., Quintini G., Franco V. Bone marrow biopsy in hemophagocytic syndrome. Virchows Arch. 2002; 441: 335-344.
  26. Ohga S., Matsuzaki A., Nishizaki M. et al. Inflammatory cytokines in virus-associated hemophagocytic syndrome. Interferon-gamma as a sensitive indicator of disease activity. Am. J. Pediatr. Hematol. Oncol. 1999; 15: 291-298.
  27. McKenna R. W., Risdall R. J., Brunning R. D. Virus-associated hemophagocytic syndrome. Hum. Pathol. 1981; 12: 395-398.
  28. McKenna R. W., Brunning R. D. Tumor of the bone marrow. Washington 1994. 447-452.
  29. Griffiths P. D. Prophylaxis against CMV infection in transplant patients. J. Antimicrob. Chemother. 1997; 39: 299-301.
  30. Erice A., Jordan M. C., Chace B. A. et al. Ganciclovir treatment of cytomegalovirus disease in transplant recipients and other immunocompromised hosts. J. A. M. A. 1987; 257 (22): 3082-3087.
  31. Meuleman N., Debruyne J., Crombez P. et al. Incidence of CMV infection and CMV disease in allogeneic transplanted patients: from no prophilaxis to preemptive treatment. Bone Marrow Transplant. 2001; 27 (1): abstr. P462; S157.
  32. Савченко В. Г., Паровичникова Е. Н., Клясова Г. А. и др. Результаты проводимых в течение 7 лет клинических исследований по лечению острых миелоидных лейкозов взрослых. Тер. арх. 1999; 7: 13-20.
  33. Савченко В. Г., Паровичникова Е. Н., Исаев В. Г. и др. Лечение острых лимфобластных лейкозов взрослых как нерешенная проблема. Там же. 2001; 7: 6-15.
  34. Гранитов В. М. Герпесвирусная инфекция. М.: Медицинская книга; 2001. 36-49.
  35. Eibl M., Zinke-Cerwenka W., Sormann S. et al. Are CMV negative donor a special risk for CMV positiv stem cell transplant recipient? Bone Marrow Transplant. 2001; 27 (1): abstr. P452; S153.
  36. Matthes S. M., Peters C., Aberrle S. et al. CMV viremia in the course of allogeneic paediatric stem cell transplantation: risk factors and impact on clinical outcome. Bone Marrow Transplant. 2001; 27 (1): abstr. P455; S154.
  37. Siennicka J., Litwinska В., Seferynska I., Palynyczko G. Diagnosis of CMV infections in patients diagnosed with acute leukemia. Med. Dosw. Mikrobiol. 1998; 50 (3-4): 285-292.
  38. Yao C., Wang Y., Fu Q. et al. Study on cytomegaloviral infection in acute leukemia patients by polymerase chain reaction. Chin. Med. J. (Engl.) 1993; 106 (11): 848-850.
  39. Crippa F., Holmberg L., Carter R. A. et al. Infectious complications after autologous CD34-selected peripheral blood stem cell transplantation. Biol. Blood Marrow Transplant. 2002; 8 (5): 281-289.
  40. Sora F., Sica S., Chiusolo P. et al. Early viral infections after autologous CD34+peripheral blood progenitor cells transplantation. Bone Marrow Transplant. 2001; 27 (1): abstr. OS223; S51.
  41. Konoplev S., Champlin R. E., Giralt S. et al. Cytomegalovirus pneumonia in adult autologous blood and marrow transplant recipients. Ibid. (8): 877-881.
  42. Wingard J. R., Chen D. Y., Burns W. H. et al. Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogeneic bone marrow transplantation. Blood 1988; 71 (5): 1432-1437.

Statistics

Views

Abstract - 67

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2020 Savchenko V.G., Troitskaya V.V., Misyurin A.V., Parovichnikova E.N., Isaev V.G., Mendeleeva L.P., Lyubimova L.S., Demidova I.A., Aksenova E.V., Filatov F.P., Garanzha T.A., Ustinova E.N., Gribanova E.O., Galstyan G.M.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:

 

© 2018 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies