Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This 35-year-old housewife was initially treated with vincristine, prednisolone and L-asparaginase for acute lymphoblastic leukemia (ALL, L1 by FAB classification) in 1988 and entered into complete remission. Ten months later she underwent bone marrow transplantation (BMT) from her HLA-identical and MLC-negative sister. The conditioning regimens consisted of busulfan 4 mg/kg/day for 4 days orally and cyclophosphamide 60 mg/kg/day for 2 days intravenously followed by cyclosporine and prednisolone for graft-versus-host disease prophylaxis. Fifty days after BMT, she suffered interstitial pneumonitis and a gastric ulcer, and was treated with a high dose of methylprednisolone and cimetidine. She experienced transient improvement, but soon cough, dyspnea and epigastralgia became worse. The specimens obtained by transbronchial alveolar lavage (BAL) and endoscopic gastric biopsy showed many giant cells containing inclusion bodies which were identified as cytomegalovirus (CMV). This time ganciclovir was started in addition to prednisolone. Then she gradually improved and after repeated BAL and the gastric biopsy after treatment showed no inclusion body in the specimen. Although leukocytopenia was significant for this patient, ganciclovir is considered to be useful for controlling CMV infection in both the lungs and stomach.
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PMID:[Good response to ganciclovir in a patient of cytomegalovirus (CMV) interstitial pneumonitis and gastric ulcer following allogeneic bone marrow transplantation for acute lymphoblastic leukemia]. 774 99

We report a 19-year-old male with acute myeloid leukemia who developed an early cytomegalovirus gastrointestinal disease with a high level of cytomegalovirus antigenemia after bone marrow transplantation. He underwent bone marrow transplantation from HLA-matched related donor. He developed acute graft-versus-host disease on day 15, and he immediately went on prednisolone. The graft-versus-host disease disappeared immediately, but he developed a severe epigastralgia on day 23. Although absolute neutrophil count was 0.5 x 10(9)/l, the pp65 cytomegalovirus antigenemia increased up to 1120 cells/slide. The endoscope examination was performed on day 29 and it showed erosive gastritis, and microscopical examination revealed nuclear inclusion bodies and positive cells of cytomegalovirus antigen. Ganciclovir treatment was started, and it continued until negative cytomegalovirus antigenemia was confirmed. He consequently discharged to outpatient without late phase CMV diseases or recurrence of AML. We assessed that the patient had two risk factors. First, he was the cytomegalovirus seropositive patient and received bone marrow from seronegative donor. Second, he was treated with prednisolone for acute graft-versus-host disease. The ganciclovir treatment turned out to be successful, but the cytomegalovirus disease developed too early to start the antigenemia guided preemptive treatment. The high-risk patients could develop the early cytomegalovirus disease even though under the status of myelosuppression after bone marrow transplantation.
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PMID:Early cytomegalovirus (CMV) gastrointestinal disease that developed 19 days after bone marrow transplantation, with a high-level of CMV antigenemia, of up to 1120 cells/slide. 1516 Mar 7