Comparison CMV Prevention Strategies
| Characteristic/ Endpoint . | Modified Antigenemia Strategy* . | Intermittent AntigenemiaGuided Strategy (randomized trial)1 . | Ganciclovir Prophylaxis at Engraftment (randomized trial)1 . |
|---|---|---|---|
| Patient characteristics | |||
| No. | 102 | 114 | 112 |
| Age (median, range) | 37 (1.3-65.0) | 37 (0.8-60.0) | 33 (1.4-59.7) |
| Serostatus before transplant | |||
| Recipient CMVseropositive | 100% | 100% | 100% |
| Donor CMV-seropositive | 48% | 61% | 68% |
| Donor status | |||
| Matched-related | 39% | 49% | 49% |
| Mismatched-related | 10% | 18% | 16% |
| Unrelated | 51% | 33% | 35% |
| Acute GVHD, grade 2-4 | 75% | 75% | 78% |
| CMV antigenemia before day 100 | |||
| Any level | 76% | 79% | 41% |
| ≥3 per duplicate slide | 58% | 70% | 24% |
| CMV disease | |||
| Before day 100 | 3.8% | 14.1%‡ | 2.7%‡ |
| After day 1001-153 | 13.1% | 8.3% | 16.5% |
| Invasive fungal disease1-155 | 5% | 6%1-154 | 16%1-154 |
| Survival | |||
| Day 100 | 83% | 84% | 87% |
| Day 180 | 77% | 73% | 71% |
| Day 400 | 66% | 61% | 59% |
| Characteristic/ Endpoint . | Modified Antigenemia Strategy* . | Intermittent AntigenemiaGuided Strategy (randomized trial)1 . | Ganciclovir Prophylaxis at Engraftment (randomized trial)1 . |
|---|---|---|---|
| Patient characteristics | |||
| No. | 102 | 114 | 112 |
| Age (median, range) | 37 (1.3-65.0) | 37 (0.8-60.0) | 33 (1.4-59.7) |
| Serostatus before transplant | |||
| Recipient CMVseropositive | 100% | 100% | 100% |
| Donor CMV-seropositive | 48% | 61% | 68% |
| Donor status | |||
| Matched-related | 39% | 49% | 49% |
| Mismatched-related | 10% | 18% | 16% |
| Unrelated | 51% | 33% | 35% |
| Acute GVHD, grade 2-4 | 75% | 75% | 78% |
| CMV antigenemia before day 100 | |||
| Any level | 76% | 79% | 41% |
| ≥3 per duplicate slide | 58% | 70% | 24% |
| CMV disease | |||
| Before day 100 | 3.8% | 14.1%‡ | 2.7%‡ |
| After day 1001-153 | 13.1% | 8.3% | 16.5% |
| Invasive fungal disease1-155 | 5% | 6%1-154 | 16%1-154 |
| Survival | |||
| Day 100 | 83% | 84% | 87% |
| Day 180 | 77% | 73% | 71% |
| Day 400 | 66% | 61% | 59% |
First transplant recipients; all patients were engrafted (absolute neutrophil count >750/μL for 2 days) with 400 days of follow-up.
Intermittent antigenemia-guided strategy v ganciclovir at engraftment, P = .002.1
Incidence in patients alive at day 100.
Before day 100.
Intermittent antigenemia-guided strategy v ganciclovir at engraftment, P = .03.1