Green M, Reyes J, Putnam P, Bueno J, Yunis E, Mieles L, Qu L, Todo S, Rowe DT; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1996 Sep 15-18; 164 (abstract no. H7).
Graduate School of Public Health and School of Medicine, Pittsburgh, PA.
A high rate of PTLD in children surviving greater than 1 month after ITx led to an effort to prevent PTLD. Since 5/94, serial QC-PCR for EBV from peripheral blood lymphocytes (PBL) were performed to guide PT with ganciclovir and Cytogam prior to onset of PTLD. A QC-PCR result greater than 200 genome/10(5) PBL for EBV seropositives pre-ITx and greater than 40 in seronegatives pre-ITx led to PT until PCRs dropped below these values. 30 children surviving greater than 1 month undergoing ITx prior to use of QC-PCR served as historic controls. 4/11 children undergoing primary ITx followed by QC-PCR have received PT. 0/7 whose PCR were always less than the PT cutoff developed PTLD. 1 control had high PCRs but did not receive PT and developed PTLD. In 3/4 PT pts a drop in QC-PCR followed PT without development of PTLD (F/U=2-12m). (Table: see text) The PCR value fell from 3000 to 20 and PT was stopped in the 4th treated child; subsequent PCRs were not obtained. He died 1 month later with disseminated aspergillosis and PTLD was found at autopsy. Surveillance with EBV QC-PCR to guide PT appears to be associated with a decreased rate of PTLD after pediatric ITx.
Publication Types:
Keywords:
- Child
- Ganciclovir
- Herpesvirus 4, Human
- Humans
- Immunotherapy
- Intestines
- Physical Therapy Modalities
- Polymerase Chain Reaction
- Transplantation, Homologous
- instrumentation
- therapy
- transplantation
- utilization
Other ID:
UI: 102234920
From Meeting Abstracts