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Prepublished online as a Blood First Edition Paper on August 22, 2002; DOI 10.1182/blood-2002-07-1982. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-07-1982v1 101/2/463    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Wolf, D. G. Articles by Kra-Oz, Z. Search for Related Content PubMed PubMed Citation Articles by Wolf, D. G. Articles by Kra-Oz, Z. Related Collections Brief Reports Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 15 January 2003, Vol. 101, No. 2, pp. 463-465 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Brief report Emergence of late cytomegalovirus central nervous system disease in hematopoietic stem cell transplant recipients Dana G. Wolf, Nell S. Lurain, Tsila Zuckerman, Ron Hoffman, Judith Satinger, Alik Honigman, Niveen Saleh, Emanuel S. Robert, Jacob M. Rowe, and Zipora Kra-Oz From the Hadassah University Hospital, Jerusalem, Israel; Rush-Presbyterian-St Luke's Medical Center, Chicago, IL; Rambam Medical Center, Haifa, Israel. Preemptive ganciclovir therapy has reduced the occurrence of early cytomegalovirus (CMV) disease after hematopoietic stem cell (HSC) transplantation. However, late disease is increasingly reported. We describe 2 patients who developed late CMV central nervous system (CNS) disease after haploidentical HSC transplantation. Direct genotypic analysis was used to examine the presence of ganciclovir resistance. One patient had a mixed viral population in the cerebrospinal fluid (CSF), with coexistent wild-type and mutant UL97 sequences. The presence of 2 different strains was confirmed by subclone sequencing of the UL54 gene. One of the strains was different from the concurrent blood strain. The second patient had resistant variant in the lungs. These cases raise concern about the changing natural history of CMV disease in HSC transplantation, with emergence of previously uncommon manifestations following prolonged prophylaxis. Under these circumstances the CNS may be a sanctuary site, where viral persistence and antiviral drug resistance could result from limited drug penetration. © 2003 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: C. Bressollette-Bodin, A. Claver, D. Boutolleau, P. Chevallier, T. Guillaume, T. Gastinne, P. Moreau, J-L. Harousseau, B.M. Imbert-Marcille, and S. Le Gouill Surgical treatment of a foscavir-resistant atypical Cytomegalovirus pneumonia in an allogeneic stem cell transplant recipient Haematologica, May 1, 2008; 93(5): e39 - e41. [Full Text] [PDF] C. Gilbert and G. Boivin Human Cytomegalovirus Resistance to Antiviral Drugs Antimicrob. Agents Chemother., March 1, 2005; 49(3): 873 - 883. [Full Text] [PDF] K. L. Springer, S. Chou, S. Li, R. H. Giller, R. Quinones, J. E. Shira, and A. Weinberg How Evolution of Mutations Conferring Drug Resistance Affects Viral Dynamics and Clinical Outcomes of Cytomegalovirus-Infected Hematopoietic Cell Transplant Recipients J. Clin. Microbiol., January 1, 2005; 43(1): 208 - 213. [Abstract] [Full Text] [PDF] A.-M. Fillet, L. Auray, S. Alain, K. Gourlain, B. M. Imbert, F. Najioullah, G. Champier, S. Gouarin, J. Carquin, N. Houhou, et al. Natural Polymorphism of Cytomegalovirus DNA Polymerase Lies in Two Nonconserved Regions Located between Domains Delta-C and II and between Domains III and I Antimicrob. Agents Chemother., May 1, 2004; 48(5): 1865 - 1868. [Abstract] [Full Text] [PDF]

	Copyright © 2003 by American Society of Hematology         Online ISSN: 1528-0020