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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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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. |
format | Online Article Text |
id | pubmed-9727199 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
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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