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Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review

Cytomegalovirus (CMV), like other herpesviruses, has the unique ability to establish latent infection with subsequent reactivation during periods of stress and immunosuppression. Herpesviruses cause potentially devastating disease, particularly in hematopoietic stem cell transplant (HSCT) recipients...

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Autores principales: Hiskey, Lisa, Madigan, Theresa, Ristagno, Elizabeth H., Razonable, Raymund R., Ferdjallah, Asmaa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9727199/
https://www.ncbi.nlm.nih.gov/pubmed/36507142
http://dx.doi.org/10.3389/fped.2022.1039938
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author Hiskey, Lisa
Madigan, Theresa
Ristagno, Elizabeth H.
Razonable, Raymund R.
Ferdjallah, Asmaa
author_facet Hiskey, Lisa
Madigan, Theresa
Ristagno, Elizabeth H.
Razonable, Raymund R.
Ferdjallah, Asmaa
author_sort Hiskey, Lisa
collection PubMed
description Cytomegalovirus (CMV), like other herpesviruses, has the unique ability to establish latent infection with subsequent reactivation during periods of stress and immunosuppression. Herpesviruses cause potentially devastating disease, particularly in hematopoietic stem cell transplant (HSCT) recipients. CMV is especially of concern in HSCT recipients given the high community seroprevalence, high risk of reactivation and high risk of transmission from HSCT donors to recipients causing primary infection after transplantation. The risk of CMV infection and severity of CMV disease varies depending on the underlying disease of the HSCT recipient, donor and recipient CMV status prior to HSCT, type of conditioning therapy in preparation for HSCT, allogeneic versus autologous HSCT, donor graft source, timing of infection in relation to HSCT, and other patient comorbidities. Different strategies exist for prevention (e.g., preemptive therapy vs. universal prophylaxis) as well as management of CMV disease (e.g., antiviral therapy, augmenting immune reconstitution, cytotoxic T-cell therapy). The purpose of this narrative review is to discuss diagnosis, prevention, and management of CMV infection and disease at different stages of HSCT, including key points illustrated through presentations of complex cases and difficult clinical scenarios. Traditional and novel strategies for CMV management will be discussed in the context of these unique clinical cases.
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spelling pubmed-97271992022-12-08 Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review Hiskey, Lisa Madigan, Theresa Ristagno, Elizabeth H. Razonable, Raymund R. Ferdjallah, Asmaa Front Pediatr Pediatrics Cytomegalovirus (CMV), like other herpesviruses, has the unique ability to establish latent infection with subsequent reactivation during periods of stress and immunosuppression. Herpesviruses cause potentially devastating disease, particularly in hematopoietic stem cell transplant (HSCT) recipients. CMV is especially of concern in HSCT recipients given the high community seroprevalence, high risk of reactivation and high risk of transmission from HSCT donors to recipients causing primary infection after transplantation. The risk of CMV infection and severity of CMV disease varies depending on the underlying disease of the HSCT recipient, donor and recipient CMV status prior to HSCT, type of conditioning therapy in preparation for HSCT, allogeneic versus autologous HSCT, donor graft source, timing of infection in relation to HSCT, and other patient comorbidities. Different strategies exist for prevention (e.g., preemptive therapy vs. universal prophylaxis) as well as management of CMV disease (e.g., antiviral therapy, augmenting immune reconstitution, cytotoxic T-cell therapy). The purpose of this narrative review is to discuss diagnosis, prevention, and management of CMV infection and disease at different stages of HSCT, including key points illustrated through presentations of complex cases and difficult clinical scenarios. Traditional and novel strategies for CMV management will be discussed in the context of these unique clinical cases. Frontiers Media S.A. 2022-11-23 /pmc/articles/PMC9727199/ /pubmed/36507142 http://dx.doi.org/10.3389/fped.2022.1039938 Text en © 2022 Hiskey, Madigan, Ristagno, Razonable and Ferdjallah. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Hiskey, Lisa
Madigan, Theresa
Ristagno, Elizabeth H.
Razonable, Raymund R.
Ferdjallah, Asmaa
Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review
title Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review
title_full Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review
title_fullStr Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review
title_full_unstemmed Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review
title_short Prevention and management of human cytomegalovirus in pediatric HSCT recipients: A review
title_sort prevention and management of human cytomegalovirus in pediatric hsct recipients: a review
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9727199/
https://www.ncbi.nlm.nih.gov/pubmed/36507142
http://dx.doi.org/10.3389/fped.2022.1039938
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