Regimen-Related Mucosal Injury of the Gut Increased the Incidence of CMV Disease after Allogeneic Bone Marrow Transplantation
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概要
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Cytomegalovirus (CMV) infection is one of the major causes of morbidity in patients undergoing allogeneic stem cell transplantation (alloSCT). The incidences of CMV antigenemia and CMV disease in 43 patients who received allogeneic bone marrow transplantation (BMT) using a reduced-intensity conditioning (RIC) regimen, which mainly consisted of fluclarabine, busulfan and total body irradiation, were compared with those in 68 patients who received a myeloablative conditioning (MAC) regimen, and risk factors for CMV antigenemia and CMV disease were identified. Before engraftment, grade 3-4 mucosal injury due to the conditioning regimen was significantly decreased in RIC patients (stomatitis: P = 0.02; diarrhea: P < 0.01). Rate of engraftment, incidences of acute graft-versus-host disease (aGVHD) and rate of corticosteroid administration were not different in RIC patients and MAC patients. Although the incidences of CMV antigenemia were not significantly different in RIC patients and MAC patients (64.1% vs. 57.8%, logrank, P = 0.59), the incidence of CMV disease was significantly decreased in RIC patients (5.4% vs. 20.3%, logrank, P = 0.04). CMV seropositivity in the patients (P < 0.01) and corticosteroid administration (P < 0.01) were revealed by multivariate analysis to be significant risk factors for CMV antigenemia. Grade II-IV aGVHD (P = 0.02) and grade 3-4 diarrhea before engraftment (P = 0.04) were revealed to be risk factors for CMV disease. The present study is the first study to show that severe diarrhea before engraftment is a significant risk factor for CMV disease. In summary, risk of CMV disease was significantly decreased in patients without severe mucosal injury of the gut due to the conditioning regimen before engraftment.
- Elsevier Inc.の論文
著者
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Noto Shun
Stem Cell Transplantation Center Hokkaido University Hospital
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Endo Tomoyuki
Stem Cell Transplantation Center Hokkaido University Hospital
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Asano S
Department Of Hematology/oncology The Institute Of Medical Science The University Of Tokyo
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Asano Shigetaka
東京大学医科学研究所 血液腫瘍内科
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Asano S
Department Of Pediatric Hematology/oncology The Institute Of Medical Science The University Of Tokyo
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Takeuchi Jin
Department Of Hematology And Rheumatology Nihon University School Of Medicine
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Ota Shuichi
北海道大学 大学院医学研究科癌診断治療学講座血液内科学分野
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Tanaka J
Stem Cell Transplantation Center Hokkaido University Hospital
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Asano Shigetaka
Institute Of Medical Science University Of Tokyo
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Asano Shigetaka
Department Of Pediatric Hematology/oncology The Institute Of Medical Science The University Of Tokyo
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Onozawa Masahiro
Stem Cell Transplantation Center Hokkaido University Hospital
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Nishio Mitsufumi
Stem Cell Transplantation Center Hokkaido University Hospital
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Kondo Takeshi
Stem Cell Transplantation Center Hokkaido University Hospital
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Hashino Satoshi
Stem Cell Transplantation Center Hokkaido University Hospital
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Takahata Mutsumi
Stem Cell Transplantation Center Hokkaido University Hospital
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Imamura M
Stem Cell Transplantation Center Hokkaido University Hospital
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YASUMOTO Atsushi
Stem Cell Transplantation Center, Hokkaido University Hospital
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OKADA Kohei
Stem Cell Transplantation Center, Hokkaido University Hospital
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KAHATA Kaoru
Stem Cell Transplantation Center, Hokkaido University Hospital
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YAMAMOTO Satoshi
Stem Cell Transplantation Center, Hokkaido University Hospital
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Asaka Masahiro
Third Department Of Internal Medicine Hokkaido University Graduate School Of Medicine
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Kawamura Takahito
Department Of Medicine Ii Hokkaido University Graduate School Of Medicine
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Asano Shigetaka
Department Of Hematology And Oncology Institute Of Medical Science University Of Tokyo
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Maruta Ichiroh
Department Of Hematology And Oncology Hokkaido University Graduate School Of Medicine
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Sato Norihiro
Translational Research And Clinical Trial Center Hokkaido University Hospital
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Tanaka Junji
Stem Cell Transplantation Center Hokkaido University Hospital
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Shigematsu Akio
Stem Cell Transplantation Center Hokkaido University Hospital
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Imamura Masahiro
Department Of Internal Medicine Saiseikai-hita Hospital
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Kahata Kaoru
Stem Cell Transplantation Center Hokkaido University Hospital
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Kondo Takeshi
北海道大学 医学研究科消化器内科学
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Onozawa Masahiro
北海道大学 医学研究科消化器内科学
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Takeuchi Jin
First Department Of Internal Medicine Nihon University School Of Medicine
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Obara Masato
Department Of Internal Medicine Ii Hokkaido University Graduate School Of Medicine
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Okada Kohei
Stem Cell Transplantation Center Hokkaido University Hospital
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Iwahashi Masahiro
Department Of Internal Medicine Saiseikai-hita Hospital
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Asaka Masahiro
Hokkaido Univ. School Of Medicine Sapporo Jpn
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Kondo Takeshi
Department Of Medicine Ii Hokkaido University Graduate School Of Medicine
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Imamura M
Department Of Internal Medicine Saiseikai-hita Hospital
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Kondo Takeshi
Department Of Gastroenterology And Hematology Hokkaido University Graduate School Of Medicine
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Shimoyama Norihiko
Department Of Clinical Pathology Hakodate Municipal Hospital
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Yasumoto Atsushi
Stem Cell Transplantation Center Hokkaido University Hospital
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Tanaka Junji
Japan Society For Hematopoietic Cell Transplantation Adult Data Management Committee
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Yamamoto Satoshi
Stem Cell Transplantation Center Hokkaido University Hospital
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Asaka M
Department Of Gastroenterology Hokkaido University Graduate School Of Medicine
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Sugita Junichi
Stem Cell Transplantation Center Hokkaido University Hospital
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Ota Shunichiro
Stem Cell Transplantation Center Hokkaido University Hospital
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Kondo Takeshi
Department Of Pathology Laboratory Of Cancer Research Hokkaido University Graduate School Of Medicine
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Tanaka Shinya
Department Of Pathology Laboratory Of Cancer Research Hokkaido University Graduate School Of Medicine
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