Prevention and Early Treatment of Opportunistic Viral Infections in Patients With Leukemia and Allogeneic Stem Cell Transplantation Recipients

A leading complication of leukemia therapy and stem cell transplantation is opportunistic viral infections. Infections caused by cytomegalovirus, herpes simplex, varicella-zoster, Epstein-Barr, and the community respiratory viruses are associated with significant morbidity and mortality in this highly immunosuppressed population. Fortunately, a growing armamentarium is allowing more effective prophylaxis of these pathogens. This article reviews the epidemiology and prophylactic strategies available for these common opportunistic viral pathogens.

If the inline PDF is not rendering correctly, you can download the PDF file here.

Correspondence: Michael G. Ison, MD, MS, Northwestern University Feinberg School of Medicine, Division of Infectious Diseases, 676 North St. Clair Street, Suite 200, Chicago, Illinois 60611. E-mail: mgison@northwestern.edu
  • 1.

    SandherrMEinseleHHebartH. Antiviral prophylaxis in patients with haematological malignancies and solid tumours: guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society for Hematology and Oncology (DGHO). Ann Oncol2006;17:10511059.

    • Search Google Scholar
    • Export Citation
  • 2.

    GriffiithsPEmeryV. Cytomegalovirus. Washington, D.C.; ASM Press; 2002.

  • 3.

    NgAPWorthLChenL. Cytomegalovirus DNAemia and disease: incidence, natural history and management in settings other than allogeneic stem cell transplantation. Haematologica2005;90:16721679.

    • Search Google Scholar
    • Export Citation
  • 4.

    ThurskyKAWorthLJSeymourJF. Spectrum of infection, risk and recommendations for prophylaxis and screening among patients with lymphoproliferative disorders treated with alemtuzumab*. Br J Haematol2006;132:312.

    • Search Google Scholar
    • Export Citation
  • 5.

    LaurentiLPiccioniPCattaniP. Cytomegalovirus reactivation during alemtuzumab therapy for chronic lymphocytic leukemia: incidence and treatment with oral ganciclovir. Haematologica2004;89:12481252.

    • Search Google Scholar
    • Export Citation
  • 6.

    KeatingMCoutreSRaiK. Management guidelines for use of alemtuzumab in B-cell chronic lymphocytic leukemia. Clin Lymphoma2004;4:220227.

    • Search Google Scholar
    • Export Citation
  • 7.

    Centers for Disease Control and Prevention; Infectious Disease Society of America; American Society of Blood and Marrow Transplantation. Guidelines for preventing opportunistic infections among hematopoietic stem cell transplant recipients. MMWR Recomm Rep2000;49:1125. Erratum in: MMWR Recomm Rep 2004;53:396.

    • Search Google Scholar
    • Export Citation
  • 8.

    BoeckhM. Current antiviral strategies for controlling cytomegalovirus in hematopoietic stem cell transplant recipients: prevention and therapy. Transpl Infect Dis1999;1:165178.

    • Search Google Scholar
    • Export Citation
  • 9.

    BoeckhMLjungmanP. Cytomegalovirus infections after hemopoietic stem cell transplantation. Philadelphia; Lippincott Williams & Wilkins; 2003.

    • Search Google Scholar
    • Export Citation
  • 10.

    MeyersJDReedECSheppDH. Acyclovir for prevention of cytomegalovirus infection and disease after allogeneic marrow transplantation. N Engl J Med1988;318:7075.

    • Search Google Scholar
    • Export Citation
  • 11.

    MillerWFlynnPMcCulloughJ. Cytomegalovirus infection after bone marrow transplantation: an association with acute graft-v-host disease. Blood1986;67:11621167.

    • Search Google Scholar
    • Export Citation
  • 12.

    IsonMGFishmanJA. Cytomegalovirus pneumonia in transplant recipients. Clin Chest Med2005;26:691705viii.

  • 13.

    LjungmanPReusserPde la CamaraR. Management of CMV infections: recommendations from the infectious diseases working party of the EBMT. Bone Marrow Transplant2004;33:10751081.

    • Search Google Scholar
    • Export Citation
  • 14.

    BowdenRASlichterSJSayersM. A comparison of filtered leukocyte-reduced and cytomegalovirus (CMV) seronegative blood products for the prevention of transfusion-associated CMV infection after marrow transplant. Blood1995;86:35983603.

    • Search Google Scholar
    • Export Citation
  • 15.

    BowdenRASlichterSJSayersMH. Use of leukocyte-depleted platelets and cytomegalovirus-seronegative red blood cells for prevention of primary cytomegalovirus infection after marrow transplant. Blood1991;78:246250.

    • Search Google Scholar
    • Export Citation
  • 16.

    MillerWJMcCulloughJBalfourHHJr. Prevention of cytomegalovirus infection following bone marrow transplantation: a randomized trial of blood product screening. Bone Marrow Transplant1991;7:227234.

    • Search Google Scholar
    • Export Citation
  • 17.

    ZaiaJA. Prevention of cytomegalovirus disease in hematopoietic stem cell transplantation. Clin Infect Dis2002;35:9991004.

  • 18.

    MeijerEBolandGJVerdonckLF. Prevention of cytomegalovirus disease in recipients of allogeneic stem cell transplants. Clin Microbiol Rev2003;16:647657.

    • Search Google Scholar
    • Export Citation
  • 19.

    BironKK. Antiviral drugs for cytomegalovirus diseases. Antiviral Res2006;71:154163.

  • 20.

    De ClercqE. Antiviral drugs in current clinical use. J Clin Virol2004;30:115133.

  • 21.

    WangLHPeckRWYinY. Phase I safety and pharmacokinetic trials of 1263W94, a novel oral anti-human cytomegalovirus agent, in healthy and human immunodeficiency virus-infected subjects. Antimicrob Agents Chemother2003;47:13341342.

    • Search Google Scholar
    • Export Citation
  • 22.

    TymsAScamansEMNaimM. The in vitro activity of acyclovir and related compounds against cytomegalovirus infections. J Antimicrob Chemother1981;8:6572.

    • Search Google Scholar
    • Export Citation
  • 23.

    GoodrichJMBowdenRAFisherL. Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant. Ann Intern Med1993;118:173178.

    • Search Google Scholar
    • Export Citation
  • 24.

    WinstonDJHoWGBartoniK. Ganciclovir prophylaxis of cytomegalovirus infection and disease in allogeneic bone marrow transplant recipients. Results of a placebo-controlled, double-blind trial. Ann Intern Med1993;118:179184.

    • Search Google Scholar
    • Export Citation
  • 25.

    BoeckhMGooleyTAMyersonD. Cytomegalovirus pp65 antigenemia-guided early treatment with ganciclovir versus ganciclovir at engraftment after allogeneic marrow transplantation: a randomized double-blind study. Blood1996;88:40634071.

    • Search Google Scholar
    • Export Citation
  • 26.

    BoeckhMZaiaJAJungD. A study of the pharmacokinetics, antiviral activity, and tolerability of oral ganciclovir for CMV prophylaxis in marrow transplantation. Biol Blood Marrow Transplant1998;4:1319.

    • Search Google Scholar
    • Export Citation
  • 27.

    SzerJDurrantSSchwarerAP. Oral versus intravenous ganciclovir for the prophylaxis of cytomegalovirus disease after allogeneic bone marrow transplantation. Intern Med J2004;34:98101.

    • Search Google Scholar
    • Export Citation
  • 28.

    TalaricoCLBurnetteTCMillerWH. Acyclovir is phosphorylated by the human cytomegalovirus UL97 protein. Antimicrob Agents Chemother1999;43:19411946.

    • Search Google Scholar
    • Export Citation
  • 29.

    MoriTAisaYShimizuT. Prevention of cytomegalovirus infection by valaciclovir after allogeneic bone marrow transplantation from an unrelated donor. Int J Hematol2006;83:266270.

    • Search Google Scholar
    • Export Citation
  • 30.

    PrenticeHGGluckmanEPowlesRL. Impact of long-term acyclovir on cytomegalovirus infection and survival after allogeneic bone marrow transplantation. European Acyclovir for CMV Prophylaxis Study Group. Lancet1994;343:749753.

    • Search Google Scholar
    • Export Citation
  • 31.

    BurnsLJMillerWKandaswamyC. Randomized clinical trial of ganciclovir vs acyclovir for prevention of cytomegalovirus antigenemia after allogeneic transplantation. Bone Marrow Transplant2002;30:945951.

    • Search Google Scholar
    • Export Citation
  • 32.

    BoeckhMGooleyTABowdenRA. Effect of high-dose acyclovir on survival in allogeneic marrow transplant recipients who received ganciclovir at engraftment or for cytomegalovirus pp65 antigenemia. J Infect Dis1998;178:11531157.

    • Search Google Scholar
    • Export Citation
  • 33.

    WinstonDJYeagerAMChandrasekarPH. Randomized comparison of oral valacyclovir and intravenous ganciclovir for prevention of cytomegalovirus disease after allogeneic bone marrow transplantation. Clin Infect Dis2003;36:749758.

    • Search Google Scholar
    • Export Citation
  • 34.

    MaJDNafzigerANVillanoSA. Maribavir pharmacokinetics and the effects of multiple-dose maribavir on cytochrome P450 (CYP) 1A2, CYP 2C9, CYP 2C19, CYP 2D6, CYP 3A, N-acetyl-transferase-2, and xanthine oxidase activities in healthy adults. Antimicrob Agents Chemother2006;50:11301135.

    • Search Google Scholar
    • Export Citation
  • 35.

    WinstonDVan BurikJPullarkat. Prophylaxis against cytomegalovirus infections with oral Maribavir in allogenic stem cell transplant recipient: results of a randomized double-blind placebo-controlled trial. Presented at the 48th American Society of Hematology Annual Meeting; Orlando Florida; December 9–12 2006.

    • Search Google Scholar
    • Export Citation
  • 36.

    IppolitiCMorganAWarkentinD. Foscarnet for prevention of cytomegalovirus infection in allogeneic marrow transplant recipients unable to receive ganciclovir. Bone Marrow Transplant1997;20:491495.

    • Search Google Scholar
    • Export Citation
  • 37.

    LjungmanPDeliliersGLPlatzbeckerU. Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients. The Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Blood2001;97:388392.

    • Search Google Scholar
    • Export Citation
  • 38.

    VisaniGMeleAGuiducciB. An observational study of once weekly intravenous ganciclovir as CMV prophylaxis in heavily pre-treated chronic lymphocytic leukemia patients receiving subcutaneous alemtuzumab. Leuk Lymphoma2006;47:25422546.

    • Search Google Scholar
    • Export Citation
  • 39.

    BassEBPoweNRGoodmanSN. Efficacy of immune globulin in preventing complications of bone marrow transplantation: a meta-analysis. Bone Marrow Transplant1993;12:273282.

    • Search Google Scholar
    • Export Citation
  • 40.

    BowdenRAFisherLDRogersK. Cytomegalovirus (CMV)-specific intravenous immunoglobulin for the prevention of primary CMV infection and disease after marrow transplant. J Infect Dis1991;164:483487.

    • Search Google Scholar
    • Export Citation
  • 41.

    BowdenRASayersMFlournoyN. Cytomegalovirus immune globulin and seronegative blood products to prevent primary cytomegalovirus infection after marrow transplantation. N Engl J Med1986;314:10061010.

    • Search Google Scholar
    • Export Citation
  • 42.

    RuutuTLjungmanPBrinchL. No prevention of cytomegalovirus infection by anti-cytomegalovirus hyperimmune globulin in seronegative bone marrow transplant recipients. The Nordic BMT Group. Bone Marrow Transplant1997;19:233236.

    • Search Google Scholar
    • Export Citation
  • 43.

    MessoriARampazzoRScroccaroGMartiniN. Efficacy of hyperimmune anti-cytomegalovirus immunoglobulins for the prevention of cytomegalovirus infection in recipients of allogeneic bone marrow transplantation: a meta-analysis. Bone Marrow Transplant1994;13:163167.

    • Search Google Scholar
    • Export Citation
  • 44.

    WittesJTKellyAPlanteKM. Meta-analysis of CMVIG studies for the prevention and treatment of CMV infection in transplant patients. Transplant Proc1996;28(6 Suppl 2):1724.

    • Search Google Scholar
    • Export Citation
  • 45.

    HowdenBPMichaelidesASpelmanDW. Cytomegalovirus viral load monitoring after allogeneic bone marrow transplantation in patients receiving antiviral prophylaxis. Bone Marrow Transplant2003;32:795800.

    • Search Google Scholar
    • Export Citation
  • 46.

    NicholsonVAWhimbeyEChamplinR. Comparison of cytomegalovirus antigenemia and shell vial culture in allogeneic marrow transplantation recipients receiving ganciclovir prophylaxis. Bone Marrow Transplant1997;19:3741.

    • Search Google Scholar
    • Export Citation
  • 47.

    van der BijWSchirmJTorensmaR. Comparison between viremia and antigenemia for detection of cytomegalovirus in blood. J Clin Microbiol1988;26:25312535.

    • Search Google Scholar
    • Export Citation
  • 48.

    MachidaUKamiMFukuiT. Real-time automated PCR for early diagnosis and monitoring of cytomegalovirus infection after bone marrow transplantation. J Clin Microbiol2000;38:25362542.

    • Search Google Scholar
    • Export Citation
  • 49.

    RazonableRRPayaCVSmithTF. Role of the laboratory in diagnosis and management of cytomegalovirus infection in hematopoietic stem cell and solid-organ transplant recipients. J Clin Microbiol2002;40:746752.

    • Search Google Scholar
    • Export Citation
  • 50.

    EmeryVCSabinCACopeAV. Application of viral-load kinetics to identify patients who develop cytomegalovirus disease after transplantation. Lancet2000;355:20322036.

    • Search Google Scholar
    • Export Citation
  • 51.

    LjungmanPAschanJLewensohn-FuchsI. Results of different strategies for reducing cytomegalovirus-associated mortality in allogeneic stem cell transplant recipients. Transplantation1998;66:13301334.

    • Search Google Scholar
    • Export Citation
  • 52.

    SalzbergerBBowdenRAHackmanRC. Neutropenia in allogeneic marrow transplant recipients receiving ganciclovir for prevention of cytomegalovirus disease: risk factors and outcome. Blood1997;90:25022508.

    • Search Google Scholar
    • Export Citation
  • 53.

    AyalaEGreeneJSandinR. Valganciclovir is safe and effective as pre-emptive therapy for CMV infection in allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant2006;37:851856.

    • Search Google Scholar
    • Export Citation
  • 54.

    BuscaAde FabritiisPGhisettiV. Oral valganciclovir as pre-emptive therapy for cytomegalovirus infection post allogeneic stem cell transplantation. Transpl Infect Dis2007;9:102107.

    • Search Google Scholar
    • Export Citation
  • 55.

    van der HeidenPLKalpoeJSBargeRM. Oral valganciclovir as pre-emptive therapy has similar efficacy on cytomegalovirus DNA load reduction as intravenous ganciclovir in allogeneic stem cell transplantation recipients. Bone Marrow Transplant2006;37:693698.

    • Search Google Scholar
    • Export Citation
  • 56.

    ReusserPEinseleHLeeJ. Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation. Blood2002;99:11591164.

    • Search Google Scholar
    • Export Citation
  • 57.

    Management of herpes virus infections following transplantation. J Antimicrob Chemother2000;45:729748.

  • 58.

    GnannJ. Herpes Simplex and Varicella Zoster Virus Infection After Hemopoietic Stem Cell or Solid Organ Transplantation. 2nd ed.Philadelphia; Lippincott Williams & Wilkins; 2003.

    • Search Google Scholar
    • Export Citation
  • 59.

    SchubertMMPetersonDEFlournoyN. Oral and pharyngeal herpes simplex virus infection after allogeneic bone marrow transplantation: analysis of factors associated with infection. Oral Surg Oral Med Oral Pathol1990;70:286293.

    • Search Google Scholar
    • Export Citation
  • 60.

    BergmannOJMogensenSCEllermann-EriksenSEllegaardJ. Acyclovir prophylaxis and fever during remission-induction therapy of patients with acute myeloid leukemia: a randomized, double-blind, placebo-controlled trial. J Clin Oncol1997;15:22692274.

    • Search Google Scholar
    • Export Citation
  • 61.

    MorrisonVARaiKRPetersonBL. Impact of therapy with chlorambucil, fludarabine, or fludarabine plus chlorambucil on infections in patients with chronic lymphocytic leukemia: Intergroup Study Cancer and Leukemia Group B 9011. J Clin Oncol2001;19:36113621.

    • Search Google Scholar
    • Export Citation
  • 62.

    LundgrenGWilczekHLonnqvistB. Acyclovir prophylaxis in bone marrow transplant recipients. Scand J Infect Dis Suppl1985;47:137144.

  • 63.

    MorfinFBilgerKBoucherA. HSV excretion after bone marrow transplantation: a 4-year survey. J Clin Virol2004;30:341345.

  • 64.

    SaralRBurnsWHLaskinOL. Acyclovir prophylaxis of herpes-simplex-virus infections. N Engl J Med1981;305:6367.

  • 65.

    EngelhardDMoragAOrR. Prevention of herpes simplex virus (HSV) infection in recipients of HLA-matched T-lymphocyte-depleted bone marrow allografts. Isr J Med Sci1988;24:145150.

    • Search Google Scholar
    • Export Citation
  • 66.

    GluckmanELotsbergJDevergieA. Prophylaxis of herpes infections after bone-marrow transplantation by oral acyclovir. Lancet1983;2:706708.

    • Search Google Scholar
    • Export Citation
  • 67.

    DignaniMCMykietiukAMicheletM. Valacyclovir prophylaxis for the prevention of herpes simplex virus reactivation in recipients of progenitor cells transplantation. Bone Marrow Transplant2002;29:263267.

    • Search Google Scholar
    • Export Citation
  • 68.

    EisenDEssellJBrounER. Clinical utility of oral valacyclovir compared with oral acyclovir for the prevention of herpes simplex virus mucositis following autologous bone marrow transplantation or stem cell rescue therapy. Bone Marrow Transplant2003;31:5155.

    • Search Google Scholar
    • Export Citation
  • 69.

    ErardVWaldACoreyL. Use of long-term suppressive acyclovir after hematopoietic stem-cell transplantation: impact on herpes simplex virus (HSV) disease and drug-resistant HSV disease. J Infect Dis2007;196:266270.

    • Search Google Scholar
    • Export Citation
  • 70.

    HannIMPrenticeHGBlacklockHA. Acyclovir prophylaxis against herpes virus infections in severely immunocompromised patients: randomised double blind trial. Br Med J (Clin Res Ed)1983;287:384388.

    • Search Google Scholar
    • Export Citation
  • 71.

    BergmannOJEllermann-EriksenSMogensenSCEllegaardJ. Acyclovir given as prophylaxis against oral ulcers in acute myeloid leukaemia: randomised, double blind, placebo controlled trial. BMJ1995;310:11691172.

    • Search Google Scholar
    • Export Citation
  • 72.

    WarkentinDIEpsteinJBCampbellLM. Valacyclovir versus acyclovir for HSV prophylaxis in neutropenic patients. Ann Pharmacother2002;36:15251531.

    • Search Google Scholar
    • Export Citation
  • 73.

    GershonASilversteinA. Varicella-Zoster Virus. 2nd ed.Washington, D.C.; ASM Press; 2002.

  • 74.

    WadeJC. Viral infections in patients with hematological malignancies. Hematology Am Soc Hematol Educ Program2006:368374.

  • 75.

    KimDHMessnerHMindenM. Factors influencing varicella zoster virus infection after allogeneic peripheral blood stem cell transplantation: low-dose acyclovir prophylaxis and pre-transplant diagnosis of lymphoproliferative disorders. Transpl Infect Dis2007; Epub ahead of print.

    • Search Google Scholar
    • Export Citation
  • 76.

    KocYMillerKBSchenkeinDP. Varicella zoster virus infections following allogeneic bone marrow transplantation: frequency, risk factors, and clinical outcome. Biol Blood Marrow Transplant2000;6:4449.

    • Search Google Scholar
    • Export Citation
  • 77.

    LjungmanPLonnqvistBGahrtonG. Clinical and subclinical reactivations of varicella-zoster virus in immunocompromised patients. J Infect Dis1986;153:840847.

    • Search Google Scholar
    • Export Citation
  • 78.

    SteerCBSzerJSasadeuszJ. Varicella-zoster infection after allogeneic bone marrow transplantation: incidence, risk factors and prevention with low-dose aciclovir and ganciclovir. Bone Marrow Transplant2000;25:657664.

    • Search Google Scholar
    • Export Citation
  • 79.

    ErardVGuthrieKAVarleyC. One-year acyclovir prophylaxis for preventing varicella-zoster virus (VZV) disease following hematopoietic cell transplantation: no evidence of rebound VZV disease after drug discontinuation. Blood2007;110:30713077.

    • Search Google Scholar
    • Export Citation
  • 80.

    BoeckhMKimHWFlowersME. Long-term acyclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation—a randomized double-blind placebo-controlled study. Blood2006;107:18001805.

    • Search Google Scholar
    • Export Citation
  • 81.

    ZaiaJALevinMJPrebludSR. Evaluation of varicella-zoster immune globulin: protection of immunosuppressed children after household exposure to varicella. J Infect Dis1983;147:737743.

    • Search Google Scholar
    • Export Citation
  • 82.

    UpToDate. AlbrechtMA. Treatment and prevention of chickenpox. Available at: www.UpToDate.com. Accessed December 31 2007.

  • 83.

    AsanoYYoshikawaTSugaS. Postexposure prophylaxis of varicella in family contact by oral acyclovir. Pediatrics1993;92:219222.

  • 84.

    WeinstockDMBoeckhMBouladF. Postexposure prophylaxis against varicella-zoster virus infection among recipients of hematopoietic stem cell transplant: unresolved issues. Infect Control Hosp Epidemiol2004;25:603608.

    • Search Google Scholar
    • Export Citation
  • 85.

    SauerbreiAPragerJHengstU. Varicella vaccination in children after bone marrow transplantation. Bone Marrow Transplant1997;20:381383.

    • Search Google Scholar
    • Export Citation
  • 86.

    HataAAsanumaHRinkiM. Use of an inactivated varicella vaccine in recipients of hematopoietic-cell transplants. N Engl J Med2002;347:2634.

    • Search Google Scholar
    • Export Citation
  • 87.

    RedmanRLNaderSZerboniL. Early reconstitution of immunity and decreased severity of herpes zoster in bone marrow transplant recipients immunized with inactivated varicella vaccine. J Infect Dis1997;176:578585.

    • Search Google Scholar
    • Export Citation
  • 88.

    PreiksaitisJCockfielsS. Epstein-Barr Virus Infection and Lymphoproliferative Disease after Hemopoietic Stem Cell or Solid Organ Transplantation. 2nd ed.Philadelphia; Lippincott Williams & Wilkins; 2003.

    • Search Google Scholar
    • Export Citation
  • 89.

    ShapiroRSMcClainKFrizzeraG. Epstein-Barr virus associated B cell lymphoproliferative disorders following bone marrow transplantation. Blood1988;71:12341243.

    • Search Google Scholar
    • Export Citation
  • 90.

    WeinstockDMAmbrossiGGBrennanC. Preemptive diagnosis and treatment of Epstein-Barr virus-associated post transplant lymphoproliferative disorder after hematopoietic stem cell transplant: an approach in development. Bone Marrow Transplant2006;37:539546.

    • Search Google Scholar
    • Export Citation
  • 91.

    ZutterMMMartinPJSaleGE. Epstein-Barr virus lymphoproliferation after bone marrow transplantation. Blood1988;72:520529.

  • 92.

    GreenfieldHMGharibMITurnerAJ. The impact of monitoring Epstein-Barr virus PCR in paediatric bone marrow transplant patients: can it successfully predict outcome and guide intervention?Pediatr Blood Cancer2006;47:200205.

    • Search Google Scholar
    • Export Citation
  • 93.

    van EsserJWNiestersHGvan der HoltB. Prevention of Epstein-Barr virus-lymphoproliferative disease by molecular monitoring and preemptive rituximab in high-risk patients after allogeneic stem cell transplantation. Blood2002;99:43644369.

    • Search Google Scholar
    • Export Citation
  • 94.

    ComoliPBassoSZeccaM. Preemptive therapy of EBV-related lymphoproliferative disease after pediatric haploidentical stem cell transplantation. Am J Transplant2007;7:16481655.

    • Search Google Scholar
    • Export Citation
  • 95.

    GruhnBMeerbachAHaferR. Pre-emptive therapy with rituximab for prevention of Epstein-Barr virus-associated lymphoproliferative disease after hematopoietic stem cell transplantation. Bone Marrow Transplant2003;31:10231025.

    • Search Google Scholar
    • Export Citation
  • 96.

    RooneyCMSmithCANgCY. Use of gene-modified virus-specific T lymphocytes to control Epstein-Barr-virus-related lymphoproliferation. Lancet1995;345:913.

    • Search Google Scholar
    • Export Citation
  • 97.

    GustafssonALevitskyVZouJZ. Epstein-Barr virus (EBV) load in bone marrow transplant recipients at risk to develop post-transplant lymphoproliferative disease: prophylactic infusion of EBV-specific cytotoxic T cells. Blood2000;95:807814.

    • Search Google Scholar
    • Export Citation
  • 98.

    PapadopoulosEBLadanyiMEmanuelD. Infusions of donor leukocytes to treat Epstein-Barr virus-associated lymphoproliferative disorders after allogeneic bone marrow transplantation. N Engl J Med1994;330:11851191.

    • Search Google Scholar
    • Export Citation
  • 99.

    IsonMG. Respiratory viral infections in transplant recipients. Curr Opin Organ Transplant2005;10:312319.

  • 100.

    NicholsWGErdmanDDHanA. Prolonged outbreak of human parainfluenza virus 3 infection in a stem cell transplant outpatient department: insights from molecular epidemiologic analysis. Biol Blood Marrow Transplant2004;10:5864.

    • Search Google Scholar
    • Export Citation
  • 101.

    NicholsWGGooleyTBoeckhM. Community-acquired respiratory syncytial virus and parainfluenza virus infections after hematopoietic stem cell transplantation: the Fred Hutchinson Cancer Research Center experience. Biol Blood Marrow Transplant2001;7(Suppl):11S5S.

    • Search Google Scholar
    • Export Citation
  • 102.

    SmithNMBreseeJSShayDK. Prevention and Control of Influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep2006;55:142.

    • Search Google Scholar
    • Export Citation
  • 103.

    IsonMG. Respiratory viral infections in transplant recipients. Antiviral Therapy2007;12:627638.

  • 104.

    IsonMGHaydenFG. Viral infections in immunocompromised patients: what's new with respiratory viruses?Curr Opin Infect Dis2002;15:355367.

    • Search Google Scholar
    • Export Citation
  • 105.

    KobashigawaJAWarner-StevensonLJohnsonBL. Influenza vaccine does not cause rejection after cardiac transplantation. Transplant Proc1993;25:27382739.

    • Search Google Scholar
    • Export Citation
  • 106.

    BrightRAShayDKShuB. Adamantane resistance among influenza A viruses isolated early during the 2005–2006 influenza season in the United States. JAMA2006;295:891894.

    • Search Google Scholar
    • Export Citation
  • 107.

    MosconaA. Neuraminidase inhibitors for influenza. N Engl J Med2005;353:13631373.

  • 108.

    ChienJWMartinPJGooleyTA. Airflow obstruction after myeloablative allogeneic hematopoietic stem cell transplantation. Am J Respir Crit Care Med2003;168:208214.

    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 97 97 6
PDF Downloads 25 25 0
EPUB Downloads 0 0 0