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Access through your institution Buy or subscribe CMV reactivation remains the main cause of viral complications after allogeneic hematopoietic stem cell transplantation (aHSCT).1 In
particular, CMV with gene mutations against antiviral drugs can lead to a high mortality rate.2 Nichols _et al._3 reported that increased viral load happened in 39% of patients because of
the latent immunosuppression after preemptive therapy. Moreover, PBSC transplantation (PBSCT) showed a faster immune recovery compared with bone marrow transplantation4, 5 and could reduce
the risk of persistent CMV antigenemia and disease.6 It appears that drug resistance should be suspected in patients who had viral load increases for more than 2 weeks of antiviral therapy
and the category and degree of host immunosuppression have great impact on drug resistance. Thus, a retrospective study was analyzed to explore the clinical risk factors and outcome for CMV
reactivation and CMV clinically refractory to antiviral chemotherapy. A total of 685 patients underwent aHSCT with a myeloablative conditioning regimen in the First Affiliated Hospital of
Soochow University between January 2011 and 31 July 2014. The median time of follow-up was 16.7 months (range 1–46) through 30 April 2015. The characteristics of the patients are summarized
in Table 1. GvHD prophylaxis consisted of cyclosporine and short term methotrexate, whereas patients with mismatched or unrelated donors also received mycophenolate mofetil as the part of
GvHD prophylaxis. Meanwhile, 441 of all patients received antithymocyte globulin (ATG) as a component of GvHD prophylaxis. Degree and the treatment of acute GvHD (aGvHD) were executed
according to the established categories and protocols.7, 8 This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to
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support REFERENCES * Meyers JD, Flournoy N, Thomas ED . Risk factors for cytomegalovirus infection after human marrow transplantation. _J Infect Dis_ 1986; 153: 478–488. Article CAS
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_J Antimicrob Chemother_ 2010; 65: 2628–2640. Article CAS PubMed Google Scholar * Nichols WG, Corey L, Gooley T, Drew WL, Miner R, Huang M _et al_. Rising pp65antigenemia during
preemptive anticytomegalovirus therapy after allogeneic hematopoietic stem cell transplantation: risk factors, correlation with DNA load, and outcomes. _Blood_ 2001; 97: 867–874. Article
CAS PubMed Google Scholar * Ottinger HD, Beelen DW, Schaefer UW, Grosse-Wilde H . Improved immune reconstitution after allotransplantation of peripheral blood stem cells instead of bone
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Beatty P, Hows J _et al_. 1994 consensus conference on acute gvhd grading. _Bone Marrow Transplant_ 1995; 15: 825. CAS PubMed Google Scholar * Deeg HJ, Lin D, Leisenring W, Boeckh M,
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Download references ACKNOWLEDGEMENTS This work was funded by Jiangsu Provincial Special Program of Medical Science (BL2012005); Jiangsu Province’s Key Medical Center (ZX201102) and the
Priority Academic; Program Development of the Jiangsu Higher Education Institutions (PAPD); National clinical key subject project; National Natural Science Foundation of China (Grant
No.81370626). AUTHOR INFORMATION Author notes * X Bao and Q Zhu: Co-first author AUTHORS AND AFFILIATIONS * Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow
University, Suzhou, China X Bao, S Xue, Y Xu, X Ma, F Chen, X Hu, Z Zhu, S Chen, A Sun, D Wu & H Qiu * Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China X
Bao, S Xue, Y Xu, X Ma, F Chen, X Hu, Z Zhu, S Chen, A Sun, D Wu & H Qiu * Suzhou Institute of Blood and Marrow Transplantation, Suzhou, China X Bao, S Xue, Y Xu, X Ma, F Chen, X Hu, Z
Zhu, S Chen, A Sun, D Wu & H Qiu * Department of Hematology, 100th Hospital of People’s Liberation Army, Suzhou, China Q Zhu * Cyrus Tang Hematology Center, Soochow University, Suzhou,
China Y Song Authors * X Bao View author publications You can also search for this author inPubMed Google Scholar * Q Zhu View author publications You can also search for this author
inPubMed Google Scholar * S Xue View author publications You can also search for this author inPubMed Google Scholar * Y Xu View author publications You can also search for this author
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inPubMed Google Scholar * H Qiu View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to H Qiu. ETHICS DECLARATIONS
COMPETING INTERESTS The authors declare no conflict of interest. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Bao, X., Zhu, Q., Xue, S. _et al._ Risk
factors of clinically refractory CMV reactivation following allogeneic HSCT: a single-center study in China. _Bone Marrow Transplant_ 51, 1625–1627 (2016).
https://doi.org/10.1038/bmt.2016.231 Download citation * Published: 17 October 2016 * Issue Date: December 2016 * DOI: https://doi.org/10.1038/bmt.2016.231 SHARE THIS ARTICLE Anyone you
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