Persistent CMV infection after allogeneic hematopoietic stem cell transplantation in a CMV-seronegative donor-to-positive recipient constellation: Development of multidrug resistance in the absence of anti-viral cellular immunity

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• 作者：Marco Herling^a ; ¹ ; L. Schrö ; der^b ; ¹ ; Sabine Awerkiew^b ; Geothy Chakupurakal^a ; Udo Holtick^a ; Rolf Kaiser^b ; Herbert Pfister^b ; Christof Scheid^a ; Veronica Di Cristanziano^b ; ^{veronica.di-cristanziano@uk-koeln.de" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Cytomegalovirus ; QuantiFERON® ; -CMV assay ; Allogeneic hematopoietic stem cell transplantation ; Multidrug resistance
• 刊名：Journal of Clinical Virology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：74
• 期：Complete
• 页码：57-60
• 全文大小：695 K

文摘

We describe a case of persistent cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) with discordant and high-risk (D−/R+) constellation of CMV serostatus. Despite the use of different and innovative antiviral strategies, viral replication could not be suppressed successfully promoting a protracted CMV colitis associated with severe gastrointestinal graft-versus-host disease (GI GVHD). We illustrate that the development of multidrug viral resistance, the failure to mount a CMV-specific cellular immune response, as confirmed by QuantiFERON^®-CMV (Qiagen) assay, and the refractory GVHD requiring prolonged immunosuppression were the main factors contributing to persistent viral replication and the fulminant unfavorable course.