Fatal CMV pneumonia associated with steroid therapy after autologous transplantation in patients previously treated with fludarabine

Bone Marrow Transplant. 1998 Mar;21(6):619-21. doi: 10.1038/sj.bmt.1701126.

Abstract

Fludarabine has been associated with an increased risk of opportunistic infections, possibly related to the induction of profound CD4+ lymphopenia. We observed two cases of cytomegalovirus pneumonia (CMV-IP) in a total of nine patients over a 5-year period who had previously received fludarabine and who proceeded to autografting. Both patients also received steroids post-transplant. CMV-IP was observed in one of 104 other autograft recipients over this time who had not received prior fludarabine. This observation suggests that the combination of fludarabine pre-transplant and steroids post-transplant may increase the risk of invasive CMV disease in autograft recipients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Cytomegalovirus Infections / etiology*
  • Doxorubicin / therapeutic use
  • Drug Synergism
  • Female
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Lymphoma, Non-Hodgkin / therapy
  • Male
  • Pneumonia, Viral / etiology*
  • Prednisolone / adverse effects*
  • Prednisone / therapeutic use
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Vidarabine / adverse effects
  • Vidarabine / analogs & derivatives*
  • Vincristine / therapeutic use
  • Viral Load

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • Vidarabine
  • fludarabine
  • Prednisone

Supplementary concepts

  • CHOP protocol