Usefulness of quantitative PCR in biopsy specimens for early therapeutic intervention in gastro-intestinal cytomegalovirus infections after allogeneic stem cell transplantation

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  • ARAI Yasuyuki
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
  • KONDO Tadakazu
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
  • KITANO Toshiyuki
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
  • HISHIZAWA Masakatsu
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
  • YAMASHITA Kouhei
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
  • KADOWAKI Norimitsu
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University
  • TAKAORI-KONDO Akifumi
    Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University

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Other Title
  • 消化管生検検体を用いた定量的PCR法による同種移植後サイトメガロウィルス胃腸炎の診断と早期治療介入の有用性
  • 臨床研究 消化管生検検体を用いた定量的PCR法による同種移植後サイトメガロウィルス胃腸炎の診断と早期治療介入の有用性
  • リンショウ ケンキュウ ショウカカンセイケンケンタイ オ モチイタ テイリョウテキ PCRホウ ニ ヨル ドウシュ イショク ゴ サイトメガロウィルス イチョウエン ノ シンダン ト ソウキ チリョウ カイニュウ ノ ユウヨウセイ

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Abstract

Gastro-intestinal cytomegalovirus infection (GI-CMV), which occurs after allogeneic stem cell transplantation (allo-SCT), is diagnosed by immunostaining of biopsied tissues obtained using a fiberscope. However, the sensitivity of this pathological diagnostic test is poor. We evaluated the suitability of using quantitative polymerase chain reaction (qPCR) to test GI-mucosal tissues for CMV. We analyzed adult patients who had undergone allo-SCT at our institute. Twentyseven specimens were collected from patients undergoing GI-fiberscopy for upper GI-symptoms after allo-SCT. Of these patients, 9 tested positive for CMV by qPCR; their symptoms resolved soon after receiving antiviral therapies for CMV. Pathological procedures detected GI-CMV in only 3 cases. In contrast, CMV qPCR was positive for 12 of 30 specimens collected from patients with lower GI-symptoms by using colon fiberscopy. Antiviral therapies were effective in all but one case. GI-CMV was diagnosed pathologically in only 5 cases. Therefore, CMV qPCR is effective for early therapeutic intervention in CMV-GI patients after allo-SCT.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 55 (12), 2400-2407, 2014

    The Japanese Society of Hematology

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