PMID- 34213545
OWN - NLM
STAT- MEDLINE
DCOM- 20211102
LR  - 20211102
IS  - 2048-7207 (Electronic)
IS  - 2048-7193 (Linking)
VI  - 10
IP  - 9
DP  - 2021 Oct 27
TI  - Incidence of CMV Infection and Disease and Adverse Events Associated with 
      Antiviral Therapy in a Retrospective Cohort of Allogeneic Hematopoietic Cell 
      Transplant Recipients at an Academic Children's Hospital.
PG  - 910-918
LID - 10.1093/jpids/piab041 [doi]
AB  - BACKGROUND: Cytomegalovirus (CMV) is a significant source of morbidity and 
      mortality among transplant recipients; the epidemiology is less understood in 
      pediatric hematopoietic cell transplantation (HCT) cohorts. Furthermore, there is 
      a paucity of data related to CMV prophylactic and preemptive strategies. METHODS: 
      A single-center retrospective observational cohort of allogeneic HCT recipients 
      at the Children's Hospital of Philadelphia January 1, 2004-December 31, 2017 was 
      constructed. Subjects were followed for 180 days after transplant to determine 
      whether they had CMV infection or disease. Data on antiviral therapy were 
      collected as were outcomes of CMV disease and adverse events (AEs) related to the 
      antiviral therapy. RESULTS: Between January 2004 and March 2017, 345 allogeneic 
      HCTs in 333 patients undergoing CMV surveillance testing were identified. CMV 
      DNAemia was detected during the 180-day follow-up in 89 (25.8%) HCTs. CMV 
      recipient-positive transplants were most likely to have CMV infection (47%). 
      Infection rates were high for those receiving a CMV-specific prophylaxis regimen 
      (50%). CMV DNAemia progressed to CMV disease 11.2% of the time. Of 224 subjects 
      receiving CMV-specific prophylaxis, 19.2% experienced >/=1 AE. Of 53 receiving 
      preemptive therapy during any CMV DNAemia episode, 32.1% experienced >/=1 AE. 
      CONCLUSIONS: CMV infection is common in pediatric allogeneic HCT recipients. The 
      CMV-specific prophylaxis regimen employed in this cohort did not effectively 
      prevent DNAemia, progression to CMV disease was uncommon, and AEs from 
      prophylaxis and preemptive therapy were frequent. Novel approaches that reduce 
      the impact of CMV on pediatric allogeneic HCT recipients are needed.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of The 
      Journal of the Pediatric Infectious Diseases Society. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Hayes, Molly
AU  - Hayes M
AD  - Antimicrobial Stewardship Program, Children's Hospital of Philadelphia, 
      Philadelphia, Pennsylvania, USA.
FAU - Newman, Alexander M
AU  - Newman AM
AUID- ORCID: 0000-0002-8467-8294
AD  - Division of Pediatrics Infectious Diseases, Anne and Robert H. Lurie Children's 
      Hospital, Chicago, Illinois, USA.
FAU - Boge, Craig L K
AU  - Boge CLK
AD  - Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of 
      Chicago, Chicago, Illinois, USA.
FAU - Galetaki, Despoina M
AU  - Galetaki DM
AD  - Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of 
      Chicago, Chicago, Illinois, USA.
FAU - Elgarten, Caitlin W
AU  - Elgarten CW
AD  - Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania, USA.
FAU - Freedman, Jason L
AU  - Freedman JL
AD  - Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania, USA.
FAU - Olson, Timothy S
AU  - Olson TS
AD  - Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, 
      Pennsylvania, USA.
FAU - Fisher, Brian T
AU  - Fisher BT
AD  - Division of Infectious Diseases, Ann & Robert H. Lurie Children's Hospital of 
      Chicago, Chicago, Illinois, USA.
AD  - Department of Biostatistics, Epidemiology and Informatics, Perelman School of 
      Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
LA  - eng
GR  - 57097/Merck Investigator Studies Program/
PT  - Journal Article
PL  - England
TA  - J Pediatric Infect Dis Soc
JT  - Journal of the Pediatric Infectious Diseases Society
JID - 101586049
RN  - 0 (Antiviral Agents)
SB  - IM
MH  - Antiviral Agents/adverse effects
MH  - Child
MH  - *Cytomegalovirus Infections/drug therapy/epidemiology
MH  - *Hematopoietic Stem Cell Transplantation/adverse effects
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Incidence
MH  - Retrospective Studies
MH  - Transplant Recipients
OTO - NOTNLM
OT  - cytomegalovirus
OT  - hematopoietic cell transplantation
OT  - pediatrics
EDAT- 2021/07/03 06:00
MHDA- 2021/11/03 06:00
CRDT- 2021/07/02 12:16
PHST- 2020/11/09 00:00 [received]
PHST- 2021/05/20 00:00 [accepted]
PHST- 2021/07/03 06:00 [pubmed]
PHST- 2021/11/03 06:00 [medline]
PHST- 2021/07/02 12:16 [entrez]
AID - 6313113 [pii]
AID - 10.1093/jpids/piab041 [doi]
PST - ppublish
SO  - J Pediatric Infect Dis Soc. 2021 Oct 27;10(9):910-918. doi: 
      10.1093/jpids/piab041.