Monitoring of cytomegalovirus, Epstein-Barr virus and adenovirus infections in hematopoietic stem cell transplant recipients

Buket Şeflek; Hale Gümüş; Mehmet Çimentepe; Serhan Küpeli; Fügen Yarkın

Makale detayları

Monitoring of cytomegalovirus, Epstein-Barr virus and adenovirus infections in hematopoietic stem cell transplant recipients

Yazarlar:

Buket Şeflek | Hale Gümüş | Mehmet Çimentepe | Serhan Küpeli | Fügen Yarkın

Yayıncı:

Cukurova University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Cukurova Medical Journal Vol.48 Issue 2, pp.432-440

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286354

pISSN:

2602-3032

Anahtar kelimeler:

Özet:

 Purpose: Haematopoietic stem cell transplant HSCT recipients with iatrogenic immunosuppression are high-risk patients for viral infections. The aim of this study was to investigate the incidence of cytomegalovirus CMV, Epstein-Barr virus EBV, and adenovirus ADV infections in HSCT recipients. Materials and Methods: We prospectively monitored 35 patients aged 0-17 years who had allogeneic n30 and autologous n5 HSCT by quantitative real-time polymerase chain reaction tests for CMV, EBV, and ADV. The monitoring was performed one week before HSCT and weekly for the first 100 days, once a month up to one year after HSCT. In addition, seropositivity for viruses was analysed by Enzyme-Linked Immuno Sorbent Assay a week before transplantation. Results: Before transplantation, all 35 100 patients who underwent HSCT were CMV IgG positive, 30 85.7 - 95 CI: 74.1-97.3 HSCT recipients were found to be EBV IgG positive. CMV infection was found in 24 80 - 95 CI: 65.7-94.3, ADV infection in 11 36.7 - 95 CI: 19.4-53.9 and EBV infection in 8 26.7 - 95 CI: 10.8-42.5 allogeneic HSCT patients. In this group, CMV DNA viral load in 8 26.7 patients, of which one 3.3 coinfected with EBV DNA and one 3.3 with ADV DNA, was higher than 1000 copiesmL which was required for pre-emptive treatment. Among 5 autologous HSCT recipients, CMV DNA was detected in 2 patients, EBV DNA in 5 and ADV DNA in 2. Pre-emptive treatment was given to 11 31.4 - 95 CI: 16-46.8; 6 CMV, 2 EBV, 1 ADV, 1 CMV-EBV and 1 CMV-ADV infection of 35 patients. Thus, the development of viral disease was prevented in 7 63.6 - 95 CI: 35.2-92.1. Of the total 35 patients, only 2 5.7 - 95 CI: 0.0-13.4 died due to viral infection. Conclusion: Early diagnosis of viral infections by prospective monitoring of viral loads in HSCT patients would be effective in preventing morbidity and mortality by ensuring timely initiation of pre-emptive therapy.

 Purpose: Haematopoietic stem cell transplant HSCT recipients with iatrogenic immunosuppression are high-risk patients for viral infections. The aim of this study was to investigate the incidence of cytomegalovirus CMV, Epstein-Barr virus EBV, and adenovirus ADV infections in HSCT recipients. Materials and Methods: We prospectively monitored 35 patients aged 0-17 years who had allogeneic n30 and autologous n5 HSCT by quantitative real-time polymerase chain reaction tests for CMV, EBV, and ADV. The monitoring was performed one week before HSCT and weekly for the first 100 days, once a month up to one year after HSCT. In addition, seropositivity for viruses was analysed by Enzyme-Linked Immuno Sorbent Assay a week before transplantation. Results: Before transplantation, all 35 100 patients who underwent HSCT were CMV IgG positive, 30 85.7 - 95 CI: 74.1-97.3 HSCT recipients were found to be EBV IgG positive. CMV infection was found in 24 80 - 95 CI: 65.7-94.3, ADV infection in 11 36.7 - 95 CI: 19.4-53.9 and EBV infection in 8 26.7 - 95 CI: 10.8-42.5 allogeneic HSCT patients. In this group, CMV DNA viral load in 8 26.7 patients, of which one 3.3 coinfected with EBV DNA and one 3.3 with ADV DNA, was higher than 1000 copiesmL which was required for pre-emptive treatment. Among 5 autologous HSCT recipients, CMV DNA was detected in 2 patients, EBV DNA in 5 and ADV DNA in 2. Pre-emptive treatment was given to 11 31.4 - 95 CI: 16-46.8; 6 CMV, 2 EBV, 1 ADV, 1 CMV-EBV and 1 CMV-ADV infection of 35 patients. Thus, the development of viral disease was prevented in 7 63.6 - 95 CI: 35.2-92.1. Of the total 35 patients, only 2 5.7 - 95 CI: 0.0-13.4 died due to viral infection. Conclusion: Early diagnosis of viral infections by prospective monitoring of viral loads in HSCT patients would be effective in preventing morbidity and mortality by ensuring timely initiation of pre-emptive therapy.

 Purpose: Haematopoietic stem cell transplant HSCT recipients with iatrogenic immunosuppression are high-risk patients for viral infections. The aim of this study was to investigate the incidence of cytomegalovirus CMV, Epstein-Barr virus EBV, and adenovirus ADV infections in HSCT recipients. Materials and Methods: We prospectively monitored 35 patients aged 0-17 years who had allogeneic n30 and autologous n5 HSCT by quantitative real-time polymerase chain reaction tests for CMV, EBV, and ADV. The monitoring was performed one week before HSCT and weekly for the first 100 days, once a month up to one year after HSCT. In addition, seropositivity for viruses was analysed by Enzyme-Linked Immuno Sorbent Assay a week before transplantation. Results: Before transplantation, all 35 100 patients who underwent HSCT were CMV IgG positive, 30 85.7 - 95 CI: 74.1-97.3 HSCT recipients were found to be EBV IgG positive. CMV infection was found in 24 80 - 95 CI: 65.7-94.3, ADV infection in 11 36.7 - 95 CI: 19.4-53.9 and EBV infection in 8 26.7 - 95 CI: 10.8-42.5 allogeneic HSCT patients. In this group, CMV DNA viral load in 8 26.7 patients, of which one 3.3 coinfected with EBV DNA and one 3.3 with ADV DNA, was higher than 1000 copiesmL which was required for pre-emptive treatment. Among 5 autologous HSCT recipients, CMV DNA was detected in 2 patients, EBV DNA in 5 and ADV DNA in 2. Pre-emptive treatment was given to 11 31.4 - 95 CI: 16-46.8; 6 CMV, 2 EBV, 1 ADV, 1 CMV-EBV and 1 CMV-ADV infection of 35 patients. Thus, the development of viral disease was prevented in 7 63.6 - 95 CI: 35.2-92.1. Of the total 35 patients, only 2 5.7 - 95 CI: 0.0-13.4 died due to viral infection. Conclusion: Early diagnosis of viral infections by prospective monitoring of viral loads in HSCT patients would be effective in preventing morbidity and mortality by ensuring timely initiation of pre-emptive therapy.

 Amaç: İyatrojenik immünsüpresyonu olan hematopoetik kök hücre transplant HKHT alıcıları viral enfeksiyonlar için yüksek riskli hastalardır. Bu çalışmanın amacı, HKHT alıcılarında cytomegalovirus CMV, Epstein-Barr virus EBV ve adenovirus ADV enfeksiyonlarının insidansını araştırmaktır. Gereç ve Yöntem: Yaşları 0-17 arasında allojenik n30 ve otolog n5 HKHTsi olan 35 hasta prospektif olarak CMV, EBV ve ADV için kantitatif gerçek zamanlı polimeraz zincir reaksiyonu testleri ile izlendi. Monitorizasyon, HKHTden bir hafta önce başladı ve HKHTden sonra ilk 100 gün için haftalık, bir yıla kadar ayda bir yapıldı. Ek olarak, virüsler için seropozitiflik, transplantasyondan bir hafta önce Enzyme-Linked Immunosorbent Assay ile analiz edildi. Bulgular: Transplantasyon öncesi HKHT yapılan 35 100 hastanın tamamı CMV IgG pozitif, 30 85.7- 95 CI: 74.1-97.3 HKHT alıcısı EBV IgG pozitif bulundu. Allojenik HKHT hastalarının 24ünde 80 - 95 CI: 65.7-94.3 CMV enfeksiyonu, 11inde 36.7 - 95 CI: 19.4-53.9 ADV enfeksiyonu ve 8inde 26.7 EBV enfeksiyonu bulundu. Bu grupta biri 3.3 EBV DNA ve biri 3.3 ADV DNA ile koenfekte olan 8 hastada 26.7 CMV DNA viral yükü preemptif tedavi için gerekli olan 1000 kopyamL üzerindeydi. Otolog 5 HKHT alıcısından CMV DNA 2 hastada, EBV DNA 5 hastada ve ADV DNA 2 hastada tespit edildi. Preemptif tedavi 35 hastanın 11ine 31.4 - 95 CI: 16-46.8; 6 CMV, 2 EBV, 1 ADV, 1 CMV-EBV ve 1 CMV-ADV enfeksiyonu verildi. Böylece 7 63.6 - 95 CI: 35.2-92.1 hastada viral hastalık gelişimi engellendi. Toplam 35 hastadan sadece 2si 5.7 - 95 CI: 0.0-13.4 viral enfeksiyon nedeniyle kaybedildi. Sonuç: HKHT hastalarında viral yüklerin prospektif olarak izlenmesi ile viral enfeksiyonların erken tanısı, preemptif tedavinin zamanında başlatılmasını sağlayarak morbidite ve mortaliteyi önlemede etkili olacaktır.

Makale detayları

Monitoring of cytomegalovirus, Epstein-Barr virus and adenovirus infections in hematopoietic stem cell transplant recipients

Yazarlar:

Buket Şeflek | Hale Gümüş | Mehmet Çimentepe | Serhan Küpeli | Fügen Yarkın

Yayıncı:

Cukurova University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Cukurova Medical Journal Vol.48 Issue 2, pp.432-440

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286354

pISSN:

2602-3032

CMV

EBV

ADV

hematopoietic stem cell transplantation

CMV

EBV

ADV

hematopoetik kök hücre transplantasyonu

Sayı

Makale detayları

Yazarlar: Buket Şeflek | Hale Gümüş | Mehmet Çimentepe | Serhan Küpeli | Fügen Yarkın

Yayıncı: Cukurova University

Ana Başlıklar: Klinik Tıp Bilimleri

Dergi: Cukurova Medical Journal Vol.48 Issue 2, pp.432-440

Belge Tipi: Makale

Yayın Tarihi: 2/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001286354

pISSN: 2602-3032

Sayı

Yazarlar:

Buket Şeflek | Hale Gümüş | Mehmet Çimentepe | Serhan Küpeli | Fügen Yarkın

Yayıncı:

Cukurova University

Ana Başlıklar:

Klinik Tıp Bilimleri

Dergi:

Cukurova Medical Journal Vol.48 Issue 2, pp.432-440

Belge Tipi:

Makale

Yayın Tarihi:

2/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001286354

pISSN:

2602-3032