Unusual viral infections (progressive multifocal leukoencephalopathy and cytomegalovirus disease) after high-dose chemotherapy with autologous blood stem cell rescue and peritransplantation rituximab

Author:

Goldberg Stuart L.1,Pecora Andrew L.1,Alter Robert S.1,Kroll Mark S.1,Rowley Scott D.1,Waintraub Stanley E.1,Imrit Kavita1,Preti Robert A.1

Affiliation:

1. From the Adult Blood and Marrow Transplantation Program, Hackensack University Medical Center, NJ; Centra State Medical Center, Freehold, NJ; and Progenitor Cell Therapy, Hackensack, NJ.

Abstract

Efforts to reduce relapse of non-Hodgkin lymphoma after autologous transplantation have included ex vivo stem cell selection and/or peritransplantation immunotherapy. The late infectious and immunologic consequences of these maneuvers are not well understood, although an increase in early cytomegaloviral disease after CD34+ stem cell selection and an alteration in immunoglobulin and T-cell recovery after peritransplantation rituximab has been noted. We report the first 2 cases of progressive multifocal leukoencephalopathy caused by JC papovavirus after autologous peripheral blood stem cell transplantation and a case each of cytomegalovirus retinitis and pneumonitis. All 4 patients experienced significant impairment of CD4 T-cell recovery, placing them at risk for these unusual viral infections. The clustering of cases is concerning because all occurred shortly after the introduction of peritransplantation rituximab into treatment protocols (4 of 62 immunotherapy recipients compared with 0 of 276 without; z = 3.595;P < .001), although a direct association with this CD20 B-cell–directed therapy remains speculative.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference28 articles.

1. Early viral complications following CD34-selected autologous peripheral blood stem cell transplantation for non-Hodgkin's lymphoma.;Miyamoto;Br J Haematol.,1998

2. Infectious complications after CD34-selected autologous peripheral blood stem cell transplantation.;Sica;Br J Haematol.,1998

3. Increased incidence of cytomegalovirus disease after autologous CD34-selected peripheral blood stem cell transplantation.;Holmberg;Blood.,1999

4. Rituximab permits in-vivo purging and collection of tumor free stem cell products prior to autologous transplantation for B-cell non-Hodgkin's lymphoma [abstract].;Goldberg;Blood.,1999

5. Polymaviruses.;Shaw;Fields Virology.,1996

Cited by 167 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3