Mehrdad Payandeh1, Mohammad Hossein Zamanian2, Bizhan Nomanpour3, Mohammad Soroush Farhadi4, Alireza Janbakhsh2, Mosayeb Rostamian5, Azam Elahi6, Somayeh Jafari6, Mohammad Dehghannejad7. 1. Hematology and Medical Oncology Dept., Kermanshah University of Medical Sciences, Kermanshah, Iran. 2. Infectious Diseases Dept., School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran. 3. Microbiology Dept., Medical school of Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran. 4. Microbiology Dept., Islamic Azad University, Tehran North Branch, Tehran, Iran. 5. Infectious Diseases Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran. 6. Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. 7. Medical School of Kermanshah, Kermanshah University of Medical Sciences, Kermanshah, Iran. drdehghannejad70@gmail.com.
Abstract
INTRODUCTION: Human Cytomegalovirus (HCMV) is the most important viral pathogen in people undergoing bone marrow transplantation (BMT). HCMV detection in the early stages makes is possible to save the patients' lives through immediate and timely treatment. The aim of this study was to investigate the status of HCMV using the real-time PCR method in BMT patients in Kermanshah, west of Iran. METHODS: HCMV monitoring was done in 120 patients who underwent BMT, 38 allogeneic cases and 82 autologous cases, using the ELISA serology test before transplantation. The participants were followed up 100 days after transplantation for HCMV detection in blood samples using real-time PCR. Preemptive therapy started with Ganciclovir and Foscarnet when the viral load was > 200 HCMV DNA copies/ml. RESULTS: Despite preemptive therapy, infection recurred in less than 1 month. HCMV recurred more frequently in patients undergoing allogenic transplation versus those receiving autologous transplantation. Recurrence was seen in 5 patients receiving allogenic transplantation. HCMV recurrence occurred in five patients with allogeneic transplantation. Twelve patients undergoing allogeneic or autologous transplantation (83%) and a virus load of > 1000 copies/ml showed HCMV-related symptoms. Three patients died, two due to HCMV-related pneumonia and the other one due to a fungal infection. CONCLUSION: Real-time PCR may be a useful method for quantification and monitoring of HCMV recurrence and may be helpful in choosing more efficient HCMV preemptive treatment in BMT recipients.
INTRODUCTION:Human Cytomegalovirus (HCMV) is the most important viral pathogen in people undergoing bone marrow transplantation (BMT). HCMV detection in the early stages makes is possible to save the patients' lives through immediate and timely treatment. The aim of this study was to investigate the status of HCMV using the real-time PCR method in BMT patients in Kermanshah, west of Iran. METHODS:HCMV monitoring was done in 120 patients who underwent BMT, 38 allogeneic cases and 82 autologous cases, using the ELISA serology test before transplantation. The participants were followed up 100 days after transplantation for HCMV detection in blood samples using real-time PCR. Preemptive therapy started with Ganciclovir and Foscarnet when the viral load was > 200 HCMV DNA copies/ml. RESULTS: Despite preemptive therapy, infection recurred in less than 1 month. HCMV recurred more frequently in patients undergoing allogenic transplation versus those receiving autologous transplantation. Recurrence was seen in 5 patients receiving allogenic transplantation. HCMV recurrence occurred in five patients with allogeneic transplantation. Twelve patients undergoing allogeneic or autologous transplantation (83%) and a virus load of > 1000 copies/ml showed HCMV-related symptoms. Three patientsdied, two due to HCMV-related pneumonia and the other one due to a fungal infection. CONCLUSION: Real-time PCR may be a useful method for quantification and monitoring of HCMV recurrence and may be helpful in choosing more efficient HCMV preemptive treatment in BMT recipients.
Entities:
Keywords:
Bone marrow transplant; Cytomegalovirus; Real-time PCR