. 2006; 23(2): 104-110

Sitomegalovir antijenemisi allojeneik periferik kök hücre transplantasyonundan sonra kemik iliği transplantasyonuna göre daha sık gözlendi

Harika Çelebi1, Klara Dalva2, Murat Özhan3, Meral Beksaç2
1Department Of Hematology, Abant Izzet Baysal University, School Of Medicine, Bolu
2Department Of Hematology, University Of Ankara, School Of Medicine, Ankara
3Department Of Infections Microbiology, University Of Ankara, School Of Medicine, Ankara

Sitomegalovirus (CMV) infeksiyonu hematopoietik kök hücre transplatasyonunu takiben görülen majör komplikasyonlardan biridir. Bizim merkezimizde CMV antijenimi tanısında rutin olarak üç yöntem kullanılmaktadır. 1) İmmunflorasan mikroskopik inceleme (IFM) 2) Akım sitometrik inceleme (ASİ) 3)Serolojik inceleme. Biz 75 transplant vakasının 18’inde ASİ ile CMV Ag saptadık. Bu vakaların 14’ünde pozitifliği IFM ile de gösterdirk. CMV Ag ‘yi FC ile periferik kan örneği (14 vaka) ve/veya bronkoalveoler lavajda (4 vaka) saptadık. Onsekiz vakada transplant yapılmıştı, periferik kök hücre transplantasyonu (PKHT)/kemik iliği transplantasyonu (KİT): 16/2. CMV Ag, PKHT’nin %34 ve KİT’da ise %7 saptandı (p<0.008). Antijenemi median 4.5 ayda gözlendi. Hastaların çoğunda, graft versus host hastalığı (GVHH) CMV Ag’ye eşlik ediyordu: Akut GVHH/kronik GVHH oranı 6/10’idi. CMV Ag pozitif 18 hastanın 16’sında CMV infeksiyon bulguları vardı. Bunların hepsinde IFM pozitifti. CMV Ag’nin saptanmasında iki metod (r=0.619, p<0.0001). Önemli bir bulgu CMV Ag ve GVHH’nın PKHT alıcılarındaki yüksek sıklığıdır.

Anahtar Kelimeler: CMV antijenemi, hematopoietik kök hücre transplantasyonu


Cytomegalovirus antigenemia is observed more frequently following allogeneic peripheral blood stem cell transplantation compared to bone marrow transplantation

Harika Çelebi1, Klara Dalva2, Murat Özhan3, Meral Beksaç2
1Department Of Hematology, Abant Izzet Baysal University, School Of Medicine, Bolu, Turkey
2Department Of Hematology, University Of Ankara, School Of Medicine, Ankara, Turkey
3Department Of Infections Microbiology, University Of Ankara, School Of Medicine, Ankara, Turkey

One of the major complications following hematopoietic stem cell transplantation (HSCT) is cytomegalovirus (CMV) infection. In our institution, three methods have been applied routinely for the diagnosis of CMV antigenemia (CMV-Ag): 1. Direct immunofluorescence microscopic (IFM) examination; 2. Flow cytometric (FC) analysis; and 3. Serological investigation. We were able to detect CMV-Ag by FC in 18 out of 75 transplanted cases. In 14 of these, positivity was confirmed by IFM as well. CMV-Ag was detected as positive by FC in samples from peripheral blood (14 cases) and/or bronchoalveolar lavage (BAL) fluid (4 cases). Eighteen patients had been transplanted [peripheral blood stem cell transplantation (PBSCT)/bone marrow transplantation (BMT): 16/2]. CMV-Ag was detected in 34% of PBSCTs and 7% of BMTs (p<0.008). Antigenemia was observed at a median of 4.5 months. In most of the patients, graft-versus-host disease (GVHD) was accompained by CMV-Ag. The ratio of acute GVHD/chronic GVHD was 6/10. Out of 18 CMV-Ag positive patients, 16 also had signs of infection. They were all positive by IFM as well. The two methods of CMV-Ag detection were correlated (r=0.619, p<0.0001). An important finding is the higher frequency of CMV-Ag and GVHD in patients who had received PBSCT.

Keywords: CMV antigenemia, hematopoietic stem cell transplantation.


Harika Çelebi, Klara Dalva, Murat Özhan, Meral Beksaç. Cytomegalovirus antigenemia is observed more frequently following allogeneic peripheral blood stem cell transplantation compared to bone marrow transplantation. . 2006; 23(2): 104-110

Sorumlu Yazar: Harika Çelebi, Türkiye


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