Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem ce... more Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem cell transplantation (HSCT). CMV-reactivation may lead to CMV-disease associated with high morbidity and mortality in patients after HSCT. In this PhD thesis I have investigated how specific T- and B-lymphocyte responses against CMV reconstitute after HSCT. In my thesis I will therefore explain both how our studies were preformed and what they have shown and furthermore I will give the reader some background in the fields of immunology, basic virology regarding CMV and the transplantation setting, which are all needed to understand the general aspect of the research. In our 1st study we analyzed the effect of different pre-transplant related factors on the viral load (VL) and the effect of the VL and VL kinetics on the risk for CMV-disease in a series of consecutive allogeneic HSCT recipients. The VL influenced the risk for CMV-disease in univariate analysis but not when different factors ...
Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem ce... more Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem cell transplantation (HSCT). CMV-reactivation may lead to CMV-disease associated with high morbidity and mortality in patients after HSCT. In this PhD thesis I have investigated how specific Tand B-lymphocyte responses against CMV reconstitute after HSCT. In my thesis I will therefore explain both how our studies were preformed and what they have shown and furthermore I will give the reader some background in the fields of immunology, basic virology regarding CMV and the transplantation setting, which are all needed to understand the general aspect of the research. In our 1 study we analyzed the effect of different pre-transplant related factors on the viral load (VL) and the effect of the VL and VL kinetics on the risk for CMV-disease in a series of consecutive allogeneic HSCT recipients. The VL influenced the risk for CMV-disease in univariate analysis but not when different factors were...
Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplan... more Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplantation (SCT). We studied viral load kinetics and correlated the viral load and other transplant factors with the development of CMV disease. We studied 162 consecutive patients who were CMV seropositive or had CMV seropositive donors. Quantification of CMV DNA was performed by real-time polymerase chain reaction. CMV DNA detected was detected in 105 of the 162 patients. The mean peak viral loads were similar at first and subsequent reactivations. The serologic status of the donors and recipients prior to SCT significantly influenced the viral load. The cumulative incidence of CMV disease was 1.8% at 100 days and 6.3% at 365 days after SCT. The peak viral load were higher in patients who developed CMV disease than in patients without CMV disease (log10 3.5; SE +/- 0.26/200,000 cells vs. log10 2.7; SE +/- 0.09/200,000 cells; p=0.02). However, in multivariate analysis, only acute graft-vers...
Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplan... more Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplantation (SCT). We studied viral load kinetics and correlated the viral load and other transplant factors with the development of CMV disease. We studied 162 consecutive patients who were CMV seropositive or had CMV seropositive donors. Quantification of CMV DNA was performed by real-time polymerase chain reaction. CMV DNA detected was detected in 105 of the 162 patients. The mean peak viral loads were similar at first and subsequent reactivations. The serologic status of the donors and recipients prior to SCT significantly influenced the viral load. The cumulative incidence of CMV disease was 1.8% at 100 days and 6.3% at 365 days after SCT. The peak viral load were higher in patients who developed CMV disease than in patients without CMV disease (log10 3.5; SE +/- 0.26/200,000 cells vs. log10 2.7; SE +/- 0.09/200,000 cells; p=0.02). However, in multivariate analysis, only acute graft-vers...
During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study w... more During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study was performed to collect data regarding risk factors and outcome of A/H1N1 in hematopoietic stem cell transplant recipients. Only verified pandemic A/H1N1 influenza strains were included: 286 patients were reported, 222 allogeneic and 64 autologous recipients. The median age was 38.3 years and the median time from transplant was 19.4 months. Oseltamivir was administered to 267 patients and 15 patients received zanamivir. One hundred and twenty-five patients (43.7%) were hospitalized. Ninety-three patients (32.5%) developed lower respiratory tract disease. In multivariate analysis, risk factors were age (OR 1.025; 1.01-1.04; P=0.002) and lymphopenia (OR 2.49; 1.33-4.67; P<0.001). Thirty-three patients (11.5%) required mechanical ventilation. Eighteen patients (6.3%) died from A/H1N1 infection or its complications. Neutropenia (P=0.03) and patient age (P=0.04) were significant risk factors for death. The 2009 A/H1N1 influenza pandemic caused severe complications in stem cell transplant recipients.
Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem ce... more Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem cell transplantation (HSCT). CMV-reactivation may lead to CMV-disease associated with high morbidity and mortality in patients after HSCT. In this PhD thesis I have investigated how specific T- and B-lymphocyte responses against CMV reconstitute after HSCT. In my thesis I will therefore explain both how our studies were preformed and what they have shown and furthermore I will give the reader some background in the fields of immunology, basic virology regarding CMV and the transplantation setting, which are all needed to understand the general aspect of the research. In our 1st study we analyzed the effect of different pre-transplant related factors on the viral load (VL) and the effect of the VL and VL kinetics on the risk for CMV-disease in a series of consecutive allogeneic HSCT recipients. The VL influenced the risk for CMV-disease in univariate analysis but not when different factors ...
Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem ce... more Human cytomegalovirus (CMV) remains an important complication in allogeneic hematopoietic stem cell transplantation (HSCT). CMV-reactivation may lead to CMV-disease associated with high morbidity and mortality in patients after HSCT. In this PhD thesis I have investigated how specific Tand B-lymphocyte responses against CMV reconstitute after HSCT. In my thesis I will therefore explain both how our studies were preformed and what they have shown and furthermore I will give the reader some background in the fields of immunology, basic virology regarding CMV and the transplantation setting, which are all needed to understand the general aspect of the research. In our 1 study we analyzed the effect of different pre-transplant related factors on the viral load (VL) and the effect of the VL and VL kinetics on the risk for CMV-disease in a series of consecutive allogeneic HSCT recipients. The VL influenced the risk for CMV-disease in univariate analysis but not when different factors were...
Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplan... more Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplantation (SCT). We studied viral load kinetics and correlated the viral load and other transplant factors with the development of CMV disease. We studied 162 consecutive patients who were CMV seropositive or had CMV seropositive donors. Quantification of CMV DNA was performed by real-time polymerase chain reaction. CMV DNA detected was detected in 105 of the 162 patients. The mean peak viral loads were similar at first and subsequent reactivations. The serologic status of the donors and recipients prior to SCT significantly influenced the viral load. The cumulative incidence of CMV disease was 1.8% at 100 days and 6.3% at 365 days after SCT. The peak viral load were higher in patients who developed CMV disease than in patients without CMV disease (log10 3.5; SE +/- 0.26/200,000 cells vs. log10 2.7; SE +/- 0.09/200,000 cells; p=0.02). However, in multivariate analysis, only acute graft-vers...
Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplan... more Cytomegalovirus (CMV) disease remains an important complication of allogeneic stem cell transplantation (SCT). We studied viral load kinetics and correlated the viral load and other transplant factors with the development of CMV disease. We studied 162 consecutive patients who were CMV seropositive or had CMV seropositive donors. Quantification of CMV DNA was performed by real-time polymerase chain reaction. CMV DNA detected was detected in 105 of the 162 patients. The mean peak viral loads were similar at first and subsequent reactivations. The serologic status of the donors and recipients prior to SCT significantly influenced the viral load. The cumulative incidence of CMV disease was 1.8% at 100 days and 6.3% at 365 days after SCT. The peak viral load were higher in patients who developed CMV disease than in patients without CMV disease (log10 3.5; SE +/- 0.26/200,000 cells vs. log10 2.7; SE +/- 0.09/200,000 cells; p=0.02). However, in multivariate analysis, only acute graft-vers...
During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study w... more During 2009, a new strain of A/H1N1 influenza appeared and became pandemic. A prospective study was performed to collect data regarding risk factors and outcome of A/H1N1 in hematopoietic stem cell transplant recipients. Only verified pandemic A/H1N1 influenza strains were included: 286 patients were reported, 222 allogeneic and 64 autologous recipients. The median age was 38.3 years and the median time from transplant was 19.4 months. Oseltamivir was administered to 267 patients and 15 patients received zanamivir. One hundred and twenty-five patients (43.7%) were hospitalized. Ninety-three patients (32.5%) developed lower respiratory tract disease. In multivariate analysis, risk factors were age (OR 1.025; 1.01-1.04; P=0.002) and lymphopenia (OR 2.49; 1.33-4.67; P<0.001). Thirty-three patients (11.5%) required mechanical ventilation. Eighteen patients (6.3%) died from A/H1N1 infection or its complications. Neutropenia (P=0.03) and patient age (P=0.04) were significant risk factors for death. The 2009 A/H1N1 influenza pandemic caused severe complications in stem cell transplant recipients.
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Papers by L. Pérez-bercoff