Lower gamma globulin level before conditioning is a risk factor for cytomegalovirus antigenemia after pediatric allogeneic stem cell transplantation.
BACKGROUND
Despite the development of early detection methods and new antiviral drugs, cytomegalovirus (CMV) infection remains a persistent and sometimes severe complication of stem cell transplantation (SCT). CMV antigenemia has become widely used for early detection of CMV infection after SCT.


PROCEDURE
We retrospectively analyzed risk factors for CMV antigenemia in pediatric patients following allogeneic SCT. We analyzed 74 pediatric patients who received allogeneic SCT at Sapporo Hokuyu Hospital between April 2007 and March 2018 and were alive over three months after SCT.


RESULTS
Of the 74 patients, 22 (29.7%) were CMV antigenemia positive. On univariate analyses, many patients with CMV antigenemia tested positive for CMV antibody before SCT (P < 0.001), and had lower gamma globulin levels before conditioning (P = 0.014). Multivariate analysis additionally confirmed that pre-SCT CMV antibody positivity (P < 0.001) and preconditioning gamma globulin levels under 655 mg/dL (P = 0.004) were independent risk factors for post-SCT CMV antigenemia.


CONCLUSIONS
These results indicate the importance of assessing gamma globulin levels in pediatric patients prior to SCT.
['Kobayashi|Ryoji|R|0000-0002-3937-0856', 'Hori|Daiki|D|0000-0003-0634-6961', 'Matsushima|Satoru|S|', 'Sano|Hirozumi|H|0000-0003-4183-4602', 'Suzuki|Daisuke|D|', 'Kobayashi|Kunihiko|K|']
D000293:Adolescent D000328:Adult D000914:Antibodies, Viral D000956:Antigens, Viral D002648:Child D002675:Child, Preschool D003587:Cytomegalovirus D003586:Cytomegalovirus Infections D005260:Female D018380:Hematopoietic Stem Cell Transplantation D006801:Humans D007223:Infant D007231:Infant, Newborn D008297:Male D012307:Risk Factors D019172:Transplantation Conditioning D014184:Transplantation, Homologous D005719:gamma-Globulins
gamma globulin risk factor CMV CMV antigenemia