Increased incidence of cytomegalovirus disease after autologous CD34- selected peripheral blood stem cell transplantation

Leona A. Holmberg, Michael Boeckh, Heather Hooper, Wendy Leisenring, Scott Rowley, Shelly Heimfeld, Oliver Press, David G. Maloney, Peter McSweeney, Lawrence Corey, Richard T. Maziarz, Frederick R. Appelbaum, William Bensinger

Research output: Contribution to journalArticle

190 Scopus citations

Abstract

High-dose therapy with autologous peripheral blood stem cell (PBSC) rescue is widely used for the treatment of malignant disease. CD34 selection of PBSC has been applied as a means of reducing contamination of the graft. Although CD34 selection results in a 2 to 3 log reduction in contaminating tumor cells without significantly delaying engraftment, many other types of cells are depleted from the CD34-enriched grafts and immune reconstitution may be impaired. In the present study, 31 cytomegalovirus (CMV)-seropositive patients who received myeloablative therapy followed by the infusion of CD34- selected autologous PBSC were assessed for the development of CMV disease in the first 100 days posttransplant. Seven patients (22.6%) developed CMV disease and 4 patients (12.9%) died from complications of their infection. In a contemporaneous group of 237 CMV-seropositive patients receiving unselected, autologous PBSC, only 10 patients (4.2%) developed CMV disease, with 5 deaths (2.1%). In a multivariate logistic regression analysis, the use of CD34-selected autologous PBSC after high-dose therapy was associated with a marked increase in the incidence of CMV disease and CMV-associated deaths.

Original languageEnglish (US)
Pages (from-to)4029-4035
Number of pages7
JournalBlood
Volume94
Issue number12
DOIs
StatePublished - Dec 15 1999

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Holmberg, L. A., Boeckh, M., Hooper, H., Leisenring, W., Rowley, S., Heimfeld, S., Press, O., Maloney, D. G., McSweeney, P., Corey, L., Maziarz, R. T., Appelbaum, F. R., & Bensinger, W. (1999). Increased incidence of cytomegalovirus disease after autologous CD34- selected peripheral blood stem cell transplantation. Blood, 94(12), 4029-4035. https://doi.org/10.1182/blood.v94.12.4029