TY - JOUR
T1 - High rate of cytomegalovirus drug resistance among patients receiving preemptive antiviral treatment after haploidentical stem cell transplantation
AU - Shmueli, Einat
AU - Or, Reuven
AU - Shapira, Michael Y.
AU - Resnick, Igor B.
AU - Caplan, Orit
AU - Bdolah-Abram, Tali
AU - Wolf, Dana G.
N1 - Funding Information:
Financial support. This work was supported by the Israel Science Foundation and the Israel Ministry of Health. Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.
PY - 2014/2/15
Y1 - 2014/2/15
N2 - We examined the rate, clinical impact, and risk factors of cytomegalovirus (CMV) drug resistance in 561 patients who underwent 616 hematopoietic stem cell transplantations (HSCTs) over 5 years. Drug resistance was exclusively identified in haploidentical (haplo)-HSCT recipients receiving preemptive therapy, among whom the rate was 14.5%. Resistance appeared after prolonged treatment (median, 70 days), was associated with higher preceding viral load (P <. 001), and was the strongest predictor for disease by multivariate analysis. The high rate of drug resistance as interlinked with severe disease in haplo-HSCT recipients suggests the potential advantage of prophylactic over preemptive treatment in high-risk patients and highlights the need for better-tolerable anti-CMV drugs.
AB - We examined the rate, clinical impact, and risk factors of cytomegalovirus (CMV) drug resistance in 561 patients who underwent 616 hematopoietic stem cell transplantations (HSCTs) over 5 years. Drug resistance was exclusively identified in haploidentical (haplo)-HSCT recipients receiving preemptive therapy, among whom the rate was 14.5%. Resistance appeared after prolonged treatment (median, 70 days), was associated with higher preceding viral load (P <. 001), and was the strongest predictor for disease by multivariate analysis. The high rate of drug resistance as interlinked with severe disease in haplo-HSCT recipients suggests the potential advantage of prophylactic over preemptive treatment in high-risk patients and highlights the need for better-tolerable anti-CMV drugs.
KW - antiviral drug resistance
KW - cytomegalovirus
KW - hematopoietic stem cell transplantation
UR - http://www.scopus.com/inward/record.url?scp=84893275395&partnerID=8YFLogxK
U2 - 10.1093/infdis/jit475
DO - 10.1093/infdis/jit475
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C2 - 23983215
AN - SCOPUS:84893275395
SN - 0022-1899
VL - 209
SP - 557
EP - 561
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 4
ER -