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Cytomegalovirus infection in children undergoing hematopoietic stem cell transplantation in Chile
Author(s) -
Paris Claudia,
Kopp Katherine,
King Alejandra,
Santolaya Maria E.,
Zepeda Ana J.,
Palma Julia
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.22060
Subject(s) - medicine , ganciclovir , hematopoietic stem cell transplantation , foscarnet , cytomegalovirus , transplantation , pneumonia , serology , incidence (geometry) , disease , immunology , pediatrics , human cytomegalovirus , viral disease , herpesviridae , virus , antibody , physics , optics
Background Cytomegalovirus (CMV) infection remains as an important cause of morbidity and mortality in children undergoing hematopoietic stem cell transplantation (HSCT). Our aim was to assess the incidence, risk factors, and outcome related to CMV infection in children after HSCT in a developing country. Methods From October 1, 1999, to December 31, 2005, we prospectively studied all patients admitted to the HSCT unit at Hospital Luis Calvo Mackenna in Santiago, Chile. Serologic studies before transplantation and weekly CMV infection surveillance (antigenemia or quantitative PCR) were routinely obtained. Patients with positive antigenemia or quantitative PCR received pre‐emptive therapy with ganciclovir, and cases of unfavorable clinical evolution, persistent positive antigenemia, or quantitative PCR after 14 days of ganciclovir were treated with foscarnet. Results Ninety‐seven patients received HSCT. Their median age was 8 years (range, 3 months to 24 years) and their overall survival was 67%. CMV reactivation was diagnosed in 26 patients. Of these, three developed CMV disease (two interstitial pneumonia, one hemorrhagic cystitis). One of the patients with pneumonia died. Risk factors identified were pre‐transplant serologic status (positive recipient), acute and chronic graft versus host disease (GvHD), GvHD prophylaxis, and treatment with antithymocyte globulin. Conclusions The rate and prognosis of CMV infection among children treated at our HSCT unit is similar to those reported from industrialized countries. These findings reflect adequate prevention and management of CMV infection within our program. Pediatr Blood Cancer 2009;53:453–458. © 2009 Wiley‐Liss, Inc.