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Graft-Versus-Tumor Effects

Adenovirus infection rates in pediatric recipients of alternate donor allogeneic bone marrow transplants receiving either antithymocyte globulin (ATG) or alemtuzumab (Campath)

Bone Marrow Transplantation volume 36, pages 1001–1008 (2005)Cite this article

Summary:

Infectious complications due to adenovirus are of increasing concern after allogeneic stem cell transplantation. Over the past 4 years, we have modified our conditioning regimens to use alemtuzumab in preference to anti-thymocyte globulin (ATG) for pediatric patients receiving stem cell transplants from alternate donors. Recent reports in adult studies implicate alemtuzumab as a risk factor for adenovirus infection. We therefore evaluated the incidence of adenovirus infection in pediatric patients receiving either ATG or alemtuzumab in their conditioning regimens. Of the 111 patients evaluated, a total of 54 patients received ATG and 57 patients received alemtuzumab. In total, 35/111 (32%) patients were infected by adenovirus, and 9/111 (8%) had adenovirus disease (AD). Adenovirus infection was greater in the alemtuzumab group than the ATG group (23/57 vs 12/54) (P=0.039) and disseminated AD was more frequent in the alemtuzumab group vs the ATG group (8/57 and 1/54 respectively) (P=0.032). The presence of Grade 3–4 graft-versus-host disease was a risk factor for adenovirus infection. Our findings highlight the fact that adenovirus infection is a frequent complication after stem cell transplantation from alternate donors in the pediatric population and that alemtuzumab increases the risk of infection compared to ATG. This work will help in identifying at-risk populations for our upcoming immunotherapy trial using adoptively transferred donor-derived adenovirus-specific cytotoxic T lymphocytes.

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Acknowledgements

This work was supported in part by a Doris Duke Distinguished Clinical Scientist Award to HEH and an Amy Strelzer Manasevit Scholar award from the NMDP to CMB.

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Authors and Affiliations

  1. Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children's Hospital, Houston, TX, USA

    G D Myers, R A Krance, I Kuehnle, H E Heslop & C M Bollard

  2. Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    G D Myers, R A Krance, I Kuehnle, G Demmler, H E Heslop & C M Bollard

  3. Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    R A Krance, H Weiss & H E Heslop

Authors
  1. G D Myers
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  2. R A Krance
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  4. I Kuehnle
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  5. G Demmler
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  6. H E Heslop
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  7. C M Bollard
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Correspondence to C M Bollard.

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Myers, G., Krance, R., Weiss, H. et al. Adenovirus infection rates in pediatric recipients of alternate donor allogeneic bone marrow transplants receiving either antithymocyte globulin (ATG) or alemtuzumab (Campath). Bone Marrow Transplant 36, 1001–1008 (2005). https://doi.org/10.1038/sj.bmt.1705164

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