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Lookup NU author(s): Professor Andrew Pearson, Professor Stephen Proctor, Dr Peter Hamilton, Professor Andrew Cant, Professor Archibald Malcolm
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Skin and rectal biopsy tissue from 34 allogeneic and 23 autologous BMT recipients was prospectively analysed for CMV using immunohistochemistry and PCR to investigate the hypothesis that target organ infection with CMV initiates and/or exacerbates GVHD. Biopsies were obtained prior to and at 3, 8 and 26 weeks after BMT and whenever GVHD was suspected, Surveillance specimens of peripheral blood leucocytes (PBL), urine and throat swabs were obtained every 2 weeks until 12 weeks after BMT, and whenever CMV was suspected. Cryostat sections were analysed immunohistochemically for CMV antigens and PBL and biopsies for CMV DNA by PCR, Of the 31 patients who engrafted, 28 (90%) developed GVHD clinically, confirmed histologically in 56 biopsies. GVHD proved clinically severe in 14 patients, 4 of whom had treatment-resistant GVHD, CMV was detected in PBL more frequently in patients with severe GVHD than in those with mild/moderate GVHD (29% vs, 7%). However, in all but one patient the onset of GVHD preceded detection of CMV. In biopsy specimens, CMV was detected in only 2 patients, 1 of whom had an exacerbation of GVHD temporally associated with CMV. Thus, despite a high incidence of GVHD in this series, with 56 episodes of GVHD in 28 patients, only 1 patient had CMV in biopsy tissue temporally associated with GVHD. This suggests that biopsy infection with CMV is not a major factor in initiating or exacerbating GVHD in this cohort. This study thus does not support a role for target organ infection with CMV in the pathogenesis of GVHD.
Author(s): Appleton, A. L., Sviland, L., Peiris, J. S. M., Taylor, C. E., Wilkes, J., Green, M. A., Pearson, A. D. J., Proctor, S. J., Hamilton, P. J., Cant, A. J., Malcolm, A. J.
Publication type: Article
Publication status: Published
Journal: Bone Marrow Transplantation
Year: 1995
Volume: 15
Issue: 4
Pages: 557-561
Print publication date: 01/04/1995
ISSN (print): 0268-3369
ISSN (electronic): 1476-5365
PubMed id: 7655381
