Reactivation and dynamics of cytomegalovirus and Epstein-Barr virus after rabbit antithymocyte globulin and cyclosporine for aplastic anemia.
Adolescent
Adult
Aged
Anemia, Aplastic
/ complications
Antilymphocyte Serum
/ adverse effects
Cyclosporine
/ adverse effects
Cytomegalovirus
Cytomegalovirus Infections
/ diagnosis
Epstein-Barr Virus Infections
/ diagnosis
Female
Herpesvirus 4, Human
Humans
Immunosuppressive Agents
/ adverse effects
Male
Middle Aged
Treatment Outcome
Viral Load
Virus Activation
Young Adult
Epstein-Barr virus
aplastic anemia
cytomegalovirus
immunosuppressive therapy
thymoglobulin
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
02
05
2019
revised:
25
07
2019
accepted:
27
07
2019
pubmed:
6
8
2019
medline:
12
2
2020
entrez:
6
8
2019
Statut:
ppublish
Résumé
This study aimed to identify the natural course of cytomegalovirus (CMV)/Epstein-Barr virus (EBV) after rabbit antithymocyte globulin and cyclosporine (rATG-CsA) for aplastic anemia (AA). In 113 prospectively observed AA patients treated with rATG-CsA, the CMV/EBV cohort was classified into two groups by baseline viremic status: no viremia (CMV-G1, n = 112; EBV-G1, n = 98) and the presence of viremia (CMV-G2, n = 1; EBV-G2, n = 13). In CMV-G1, the mean CMV load increased up to 3 months but was completely resolved from 6 months. The mean EBV load of EBV-G1 showed a peak at 1 month and then gradually decreased over time but remained detectable throughout the observation period. EBV-G2 showed fluctuating EBV dynamics. With reactivation rates of 38.4% in CMV-G1 and 62.2% in EBV-G1, a longer time to rATG-CsA from diagnosis and a lower absolute lymphocyte count at 1 month from rATG-CsA were significantly associated with CMV and EBV reactivation, respectively. The mean peak CMV and EBV loads of patients with CMV-related (3.5%) and EBV-related (0.9%) diseases were evidently higher than those of the remaining patients without CMV and EBV diseases in the respective cohort. Considering frequent reactivation and distinct courses of CMV/EBV, virologic surveillance is recommended after rATG-CsA for AA.
Substances chimiques
Antilymphocyte Serum
0
Immunosuppressive Agents
0
Cyclosporine
83HN0GTJ6D
thymoglobulin
D7RD81HE4W
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
433-441Subventions
Organisme : Ministry of Science & ICT of Korea
ID : NRF-2018M3A9E8020866
Informations de copyright
© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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