Abstract
The etiology of cytomegalovirus (CMV), human herpesvirus-6 (HHV-6), and Epstein-Barr virus (EBV) reactivation and the potential for complications following cytotoxic chemotherapy in the absence of allogeneic transplantation are not clearly understood. Patients with adult T cell leukemia (ATL) are susceptible to opportunistic infections. In this study, the incidence, kinetics and clinical significance of reactivation of CMV, HHV-6, and EBV in ATL patients were investigated. Viral DNA in a total of 468 plasma samples from 34 patients was quantified using real-time PCR. The probability of CMV, HHV-6, and EBV reactivation by 100 days after the start of chemotherapy was 50.6%, 52.3%, and 21.6%, respectively. Although most CMV reactivations were self-limited, plasma CMV DNA tended to persist or increase if the CMV DNA levels in plasma reached ≥104copies/ml. CMV reactivation was negatively associated with survival, but the P-value for this association was near the borderline of statistical significance (P=0.052). One patient developed fatal interstitial pneumonia concomitant with peak CMV DNA accumulation (1.6×106copies/ml plasma). Most HHV-6 and EBV reactivations were self-limited, and no disease resulting from HHV-6 or EBV was confirmed. HHV-6 and EBV reactivation were not associated with reduced survival (P=0.35 and 0.11, respectively). These findings demonstrated that subclinical reactivation of CMV, HHV-6, and EBV were common in ATL patients receiving chemotherapy. There were differences in the viral reactivation patterns among the three viruses. A CMV load ≥104copies/ml plasma was indicative of subsequent exacerbation of CMV reactivation and developing serious clinical course.
| Original language | English |
|---|---|
| Pages (from-to) | 702-709 |
| Number of pages | 8 |
| Journal | Journal of Medical Virology |
| Volume | 83 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 01-04-2011 |
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All Science Journal Classification (ASJC) codes
- Virology
- Infectious Diseases
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High incidence of cytomegalovirus, human herpesvirus-6, and Epstein-Barr virus reactivation in patients receiving cytotoxic chemotherapy for Adult T cell leukemia. / Ogata, Masao; Satou, Takako; Kawano, Rie; Yoshikawa, Tetsushi; Ikewaki, Junji; Kohno, Kazuhiro; Ando, Takeaki; Miyazaki, Yasuhiko; Ohtsuka, Eiichi; Saburi, Yoshio; Kikuchi, Hiroshi; Saikawa, Tetsunori; Kadota, Jun ichi.
In: Journal of Medical Virology, Vol. 83, No. 4, 01.04.2011, p. 702-709.Research output: Contribution to journal › Article
TY - JOUR
T1 - High incidence of cytomegalovirus, human herpesvirus-6, and Epstein-Barr virus reactivation in patients receiving cytotoxic chemotherapy for Adult T cell leukemia
AU - Ogata, Masao
AU - Satou, Takako
AU - Kawano, Rie
AU - Yoshikawa, Tetsushi
AU - Ikewaki, Junji
AU - Kohno, Kazuhiro
AU - Ando, Takeaki
AU - Miyazaki, Yasuhiko
AU - Ohtsuka, Eiichi
AU - Saburi, Yoshio
AU - Kikuchi, Hiroshi
AU - Saikawa, Tetsunori
AU - Kadota, Jun ichi
PY - 2011/4/1
Y1 - 2011/4/1
N2 - The etiology of cytomegalovirus (CMV), human herpesvirus-6 (HHV-6), and Epstein-Barr virus (EBV) reactivation and the potential for complications following cytotoxic chemotherapy in the absence of allogeneic transplantation are not clearly understood. Patients with adult T cell leukemia (ATL) are susceptible to opportunistic infections. In this study, the incidence, kinetics and clinical significance of reactivation of CMV, HHV-6, and EBV in ATL patients were investigated. Viral DNA in a total of 468 plasma samples from 34 patients was quantified using real-time PCR. The probability of CMV, HHV-6, and EBV reactivation by 100 days after the start of chemotherapy was 50.6%, 52.3%, and 21.6%, respectively. Although most CMV reactivations were self-limited, plasma CMV DNA tended to persist or increase if the CMV DNA levels in plasma reached ≥104copies/ml. CMV reactivation was negatively associated with survival, but the P-value for this association was near the borderline of statistical significance (P=0.052). One patient developed fatal interstitial pneumonia concomitant with peak CMV DNA accumulation (1.6×106copies/ml plasma). Most HHV-6 and EBV reactivations were self-limited, and no disease resulting from HHV-6 or EBV was confirmed. HHV-6 and EBV reactivation were not associated with reduced survival (P=0.35 and 0.11, respectively). These findings demonstrated that subclinical reactivation of CMV, HHV-6, and EBV were common in ATL patients receiving chemotherapy. There were differences in the viral reactivation patterns among the three viruses. A CMV load ≥104copies/ml plasma was indicative of subsequent exacerbation of CMV reactivation and developing serious clinical course.
AB - The etiology of cytomegalovirus (CMV), human herpesvirus-6 (HHV-6), and Epstein-Barr virus (EBV) reactivation and the potential for complications following cytotoxic chemotherapy in the absence of allogeneic transplantation are not clearly understood. Patients with adult T cell leukemia (ATL) are susceptible to opportunistic infections. In this study, the incidence, kinetics and clinical significance of reactivation of CMV, HHV-6, and EBV in ATL patients were investigated. Viral DNA in a total of 468 plasma samples from 34 patients was quantified using real-time PCR. The probability of CMV, HHV-6, and EBV reactivation by 100 days after the start of chemotherapy was 50.6%, 52.3%, and 21.6%, respectively. Although most CMV reactivations were self-limited, plasma CMV DNA tended to persist or increase if the CMV DNA levels in plasma reached ≥104copies/ml. CMV reactivation was negatively associated with survival, but the P-value for this association was near the borderline of statistical significance (P=0.052). One patient developed fatal interstitial pneumonia concomitant with peak CMV DNA accumulation (1.6×106copies/ml plasma). Most HHV-6 and EBV reactivations were self-limited, and no disease resulting from HHV-6 or EBV was confirmed. HHV-6 and EBV reactivation were not associated with reduced survival (P=0.35 and 0.11, respectively). These findings demonstrated that subclinical reactivation of CMV, HHV-6, and EBV were common in ATL patients receiving chemotherapy. There were differences in the viral reactivation patterns among the three viruses. A CMV load ≥104copies/ml plasma was indicative of subsequent exacerbation of CMV reactivation and developing serious clinical course.
UR - http://www.scopus.com/inward/record.url?scp=79951532169&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79951532169&partnerID=8YFLogxK
U2 - 10.1002/jmv.22013
DO - 10.1002/jmv.22013
M3 - Article
C2 - 21328386
AN - SCOPUS:79951532169
VL - 83
SP - 702
EP - 709
JO - Journal of Medical Virology
JF - Journal of Medical Virology
SN - 0146-6615
IS - 4
ER -