Reactivation of Human Herpes Virus-6 After Pediatric Stem Cell Transplantation
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Le résumé fourni par la source
BACKGROUND AND METHODS: To study clinical symptoms, timing and consequences of human herpesvirus-6 (HHV-6) reactivation after pediatric allogeneic stem cell transplantation (SCT), HHV-6 was investigated by plasma polymerase chain reaction in a cohort of 106 pediatric SCT recipients. RESULTS: HHV-6 viremia was detected post-SCT in 48% of the patients with a median time of onset at 20 days after SCT. In week 3 and 4 post-SCT, HHV-6 is the most common infectious agent detected. In up to 30% of the patients with fever of unknown origin, HHV-6 was the only detected infectious agent to explain fever. Patients transplanted with an unrelated donor or receiving serotherapy were at increased risk of HHV-6 reactivation. The onset of HHV-6 reactivation coincided with the appearance of lymphocytes and monocytes in peripheral blood. Treatment with alemtuzumab (MabCampath) delayed both lymphocyte and monocyte engraftment and, concomitantly, onset of HHV-6 reactivation was delayed in those cases. HHV-6 reactivation was not associated with an increased incidence of acute graft-versus-host disease (GvHD). However, progression to grade II-IV GvHD was in 9 of 10 patients associated with HHV-6 reactivation before GvHD (P = 0.006) and HHV-6 was the only infection with such an association. CONCLUSIONS: HHV-6 frequently reactivates after pediatric SCT around the time of mononuclear cell engraftment and is associated with an increased severity of GvHD. HHV-6 may explain fever of unknown origin in 30% of the patients early after SCT. Assessment of HHV-6 reactivation in patients early after SCT can be instrumental for clinical decision making.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Reactivation of Human Herpes Virus-6 After Pediatric Stem Cell Transplantation
- Date Crossref
- 01/10/2015
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Leiden University Medical Center ‡Department of Medical Statistics and Bioinformatics pays non établi dans la noticeOrganisme public
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University of Toronto Hospital for Sick Children pays non établi dans la noticeUniversité ou école supérieure
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Hospital for Sick Children pays non établi dans la noticeÉtablissement de santé
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SickKids Foundation pays non établi dans la noticeOrganisation à but non lucratif
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Department of Pediatrics pays non établi dans la noticeInstitution
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Department of Medical Microbiology pays non établi dans la noticeInstitution
‡Department of Medical Statistics and Bioinformatics — Leiden University Medical Center, Hospital for Sick Children — University of Toronto et Hospital for Sick Children, avec 3 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.