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Prophylaxe und Therapie von Cytomegalie-Infektionen nach Knochenmarktransplantation

  • Conference paper
Patient — Infektion — Immunglobulin

Zusammenfassung

Die Beziehung zwischen Knochenmarktransplantation und Infektionsneigung läßt sich durch zwei Punkte charakterisieren:

  1. 1.

    Die Konditionierung zur Knochenmarktransplantation ist die stärkste Form einer Immunsuppression, die für den Menschen denkbar ist. Sie wird durchgeführt, um maligne Restzellpopulationen zu beseitigen und andererseits durch die Suppression der Immunabwehr ein Engraftment zu ermöglichen. Die Abb. 1 zeigt unser Konditionierungsprotokoll zur Vorbereitung einer Knochenmarktransplantation bei akuter Leukämie und schwerer aplastischer Anämie.

  2. 2.

    Die Folgen dieser Immunsuppression haben Modellcharakter für immunkompromittierte Patienten im Rahmen anderer Erkrankungen bzw. Therapieformen. Der Modellcharakter ergibt sich aus der Tatsache, daß ein Patient in den ersten 6–24 Monaten nach Transplantation erneut eine normale Immunkompetenz aufbauen muß.

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Literatur

  1. Buckner CD, Clift RA, Thomas ED, Hersman J, Sanders JE, Stewart PS, Wade JC, Murphy M, Counts G, Meyers JD (1983) Early infectious complications in allogeneic marrow transplant recipients with acute leukemia: effects of prophylactic measures. Infection 11: 243–250

    Article  PubMed  CAS  Google Scholar 

  2. Peterson PK, McGlave P, Ramsay NKC, Rhame F, Cohen E, Perry GS, Goldman AJ, Kersey J (1983) A prospective study of infectious diseases following bone marrow transplantation: Emergence of aspergillus and cytomegalovirus as the major causes of mortality. Infect Control 4: 81–81

    PubMed  CAS  Google Scholar 

  3. Pinching AJ, Cohen J (1983) Infection in the immunocompromised patient: selected topics in presentation and treatment. Clinics in Immunol and Allergy 3: 305–329

    Google Scholar 

  4. Watson JG (1983) Problems of infection after bone marrow transplantation. J Clin Path 36: 683–692

    Article  PubMed  CAS  Google Scholar 

  5. Kay HEM, Watson JG, Jameson B, Morgenstern GR, Docoles RL (1983) Infections after bone marrow transplantation using cyclosporine. Transplantation 36: 491–495

    Article  PubMed  CAS  Google Scholar 

  6. Bortin MM, Kay HEM, Gale RP, Rimm AA (1982) Factors associated with interstitial Pneumonitis after bone marrow transplantation for acute leukaemia. The Lancet I: 437–439

    Article  Google Scholar 

  7. Betts RF (1982) Cytomegalovirus infection in transplant patients. Prog Med Virol 28: 44–64

    PubMed  CAS  Google Scholar 

  8. Meyers JD, Flournoy N, Thomas ED (1982) Nonbacterial pneumonia after allogeneic marrow transplantation: A review often year’s experience. Rev Inf Dis 4: 1119–1131

    Article  CAS  Google Scholar 

  9. Meyers JD, Flournoy N, Thomas ED (1980) Cytomegalovirus infection and specific cell-mediated immunity after marrow transplant. J Infect Dis 142: 816–824

    Article  PubMed  CAS  Google Scholar 

  10. Meyers JD, Flournoy N, Wade JC, Hackman RC, McDongall JK, Neiman PE, Thomas ED (1983) Biology of interstitial pneumonia after bone marrow transplantation. In: Recent advances in bone marrow transplantation (Ed. R P Gale). A. R. Liss, New York, 405–423

    Google Scholar 

  11. Ostendorf P, Ehninger G, Kallmayer ML, Link H, Schüch K, Wilms K, Müller C, Wernet P, Dopfer H. Niethammer D, Frommhold W, Breitling G, Schneider W, Waller HD, Bone marrow transplantation for acute leukemia in second or subsequent remission. (In Press)

    Google Scholar 

  12. Hersman J, Meyers JD, Thomas ED, Buckner CD, Clift R (1982) The effect of granulocyte transfusions on the incidence of cytomegalovirus infection after allogeneic marrow transplantation. Ann Intern Med 96: 149–152

    PubMed  CAS  Google Scholar 

  13. Winston DJ, Ho WG, Howell CL, Miller MJ, Mickey RMWJ, Lin CH, Gale RP (1980) Cytomegalovirus infections associated with leukocyte transfusions. Ann Intern Med 93: 671–675

    PubMed  CAS  Google Scholar 

  14. Zinkernagel RM (1978) Speculations on the role of major transplantation antigens in cell-mediated immunity against intracellular parasites. Curr Top Microbiol Immunol 82: 113–138

    PubMed  CAS  Google Scholar 

  15. Kraemer KG, Neiman PE, Reeves WC, Thomas ED (1978) Prophylactic adenine arabinoside following marrow transplantation. Transplant Proc 10: 237 ff.

    Google Scholar 

  16. Meyers JD, McGuffin RW, Neiman PE, Singer JW, Thomas ED (1980) Toxicity and efficacy of human leukocyte interferon for treatment of cytomegalovirus pneumonia after marrow transplantation. J Infect Dis 141: 555 ff.

    Article  PubMed  CAS  Google Scholar 

  17. Meyers JD, McGuffin RW, Bryson YJ, Cantell K, Thomas ED (1982) Treatment of cytmegalovirus pneumonia after marrow transplant with combined vidarabine and human leukocyte interferon. J Inf Dis 146: 80 ff.

    Article  CAS  Google Scholar 

  18. Wade JC, Hintz M, McGuffin RW, Springmeyer SC, Connor JD, Meyers JD (1982) Treatment of cytomegalovirus pneumonia with high-dose acyclovir. Am J Med 73: Suppl. 249–256

    Article  PubMed  CAS  Google Scholar 

  19. Wade JC, McGuffin RW, Springmeyer SC, Newton B, Singer JW, Meyers JD (1983) Treatment of cytomegaloviral pneumonia with high-dose acyclovir and human leukocyte interferon. J Infect Dis 148: 557–562

    Article  PubMed  CAS  Google Scholar 

  20. Winston DJ, Ho WG, Schroff RW, Bartoni K, Champlin RE, Gale RP (1982) Initial studies of safety and tolerance of recombinant leukocyte A interferon in bone marrow transplant recipients. Presented at the 22nd Interscience Conference on Antimicrobial Agents and Chemotherapy Miami Beach, Fl.

    Google Scholar 

  21. Meyers JD, Day LM, Lum LG, Sullivan KM (1983) Recombinant leukocyte a interferon for the treatment of serious viral infections after marrow transplant: a phase I study. I Infect Dis 48: 551–556

    Article  Google Scholar 

  22. Meyers JD, Wade JC, McGuffin RW, Springmeyer SC, Thomas ED (1983) The use of acyclovir for cytomegalovirus infections in the immunocompromised host. J Antimicrob Chemother 12: Suppl. B, 181–193

    PubMed  Google Scholar 

  23. Meyers JD, Leszczynski J, Zaia JA, Flournoy N, Newton B, Syndmon DR, Wright GG, Lovin MJ, Thomas ED (1983) Prevention of cytomegalovirus infection by cytomegalovirus immune globulin after marrow transplantation. Ann Intern Med 98: 442–446

    PubMed  CAS  Google Scholar 

  24. Winston DJ, Ho WG, Rasmussen LE, Lin CH, Chu CL, Merigan TC, Gale RP (1982) Use of intravenous immune globulin in patients receiving bone marrow transplants. J Clin Immunol 2: Suppl. April, 42S–47S

    Article  PubMed  CAS  Google Scholar 

  25. Winston DJ, Pollard RB, Ho WG, Gallagber JG, Rasmussen LE, Huang SN-Y, Lin Ch-H, Gossett TG, Merigan TC, Gale RP (1982) Cytomegalovirus immune plasma in bone marrow transplant recipients. Ann Intern Med 97: 11–18

    PubMed  CAS  Google Scholar 

  26. O’Reilly RJ, Reich L, Gold J, Kirkpatrick D, Dinsmore R, Kapoor N, Condie R (1983) A randomized trial of intravenous hyperimmune globulin for the prevention of cytomegalovirus (CMV) infections following marrow transplantation: preliminary results. Transpl Proc 15: 1405–1411

    Google Scholar 

  27. Kubanek B, Ernst P, Schäfer U, Ostendorf P, Wolf H: A controlled trial of intravenous hyperimmunglobulin in the prevention of cytomegalovirus infection in bone marrow transplant recipients. (In press)

    Google Scholar 

  28. Osborn JE (1981) Cytomegalovirus: Pathogenicity, immunology and vaccine initiatives. J Infect Dis 143: 618–630

    Article  PubMed  CAS  Google Scholar 

  29. Colacino JM, Lpez C (1983) Efficacy and selectivity of some nucleoside analogs as anti-human cytomegalovirus agents. Antimicrobial Agents and Chemother 24: 505–508

    CAS  Google Scholar 

  30. Mar E-Ch, Cheng Y-C, Huang E-S (1983) Effect of 9-(l,3-Dihydroxy-2-Propoxymethyl) guanine on human cytomegalovirus replication in vitro. Antimicrobial Agents and Chemother 24: 518–521

    CAS  Google Scholar 

  31. Hirsch MS, Schooley RT (1983) Treatment of herpesvirus infections (second of two parts) NEJM 309: 1034–1039

    Article  PubMed  CAS  Google Scholar 

  32. Balfour HH (1983) Cytomegalovirus disease: Can it be prevented? Ann Intern Med 98: 544–546

    PubMed  Google Scholar 

  33. Kloft M (1983) Zytomegalie-Virus-Infektion. Neue Möglichkeiten zu Prophylaxe und Therapie. Fortschr Med 101: 1155–1160

    PubMed  CAS  Google Scholar 

  34. Winston DJ, Ho WG, Champlin RE, Gale RP (1983) Treatment and prevention of interstitial pneumonia associated with bone marrow transplantation. In: Recent advances in bone marrow transplantation (Ed. R P Gale) A. R. Liss, New York, 405–423

    Google Scholar 

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Authors
  1. P. Ostendorf
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  2. G. Ehninger
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  3. H. Link
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  4. P. Wernet
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  5. R. Dopfer
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  6. D. Niethammer
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Editor information

Editors and Affiliations

  1. Zentrum der Kinderheilkunde, Klinikum der J.-W.-Goethe-Universität, Theodor-Stern-Kai 7, 6000, Frankfurt 70, Germany

    Bernhard Kornhuber

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© 1984 Springer-Verlag Berlin Heidelberg

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Ostendorf, P., Ehninger, G., Link, H., Wernet, P., Dopfer, R., Niethammer, D. (1984). Prophylaxe und Therapie von Cytomegalie-Infektionen nach Knochenmarktransplantation. In: Kornhuber, B. (eds) Patient — Infektion — Immunglobulin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69877-4_10

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  • DOI: https://doi.org/10.1007/978-3-642-69877-4_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-13607-1

  • Online ISBN: 978-3-642-69877-4

  • eBook Packages: Springer Book Archive

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