RapamycinFungusV1, Main, Exploration, bibRecord, 000355

Effect of Sirolimus Exposure on the Need for Preemptive Antiviral Therapy for Cytomeglovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.

Identifieur interne : 000355 ( Main/Exploration ); précédent : 000354; suivant : 000356

Effect of Sirolimus Exposure on the Need for Preemptive Antiviral Therapy for Cytomeglovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.

Auteurs : Beatriz Guglieri-Lopez [Espagne] ; Alejandro Perez-Pitarch [Espagne] ; Irene Garcia-Cadenas [Espagne] ; Estela Gimenez [Espagne] ; Pere Barba [Espagne] ; Nuria Rabella [Espagne] ; Juan Carlos Hernandez-Boluda ; Laura Fox [Espagne] ; David Valcarcel [Espagne] ; Albert Esquirol [Espagne] ; Rafael Ferriols-Lisart [Espagne] ; Jorge Sierra [Espagne] ; Carlos Solano [Espagne] ; David Navarro [Espagne] ; Rodrigo Martino [Espagne] ; José Luis Pi Ana [Espagne]

Source :

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation [ 1523-6536 ] ; 2019.

RBID : pubmed:30639821

Descripteurs français

KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Antiviraux (usage thérapeutique), Femelle (MeSH), Humains (MeSH), Immunosuppresseurs (effets indésirables), Infections à cytomégalovirus (prévention et contrôle), Infections à cytomégalovirus (étiologie), Mâle (MeSH), Prémédication (méthodes), Relation dose-effet des médicaments (MeSH), Sirolimus (effets indésirables), Sirolimus (sang), Transplantation de cellules souches hématopoïétiques (effets indésirables), Transplantation homologue (MeSH), Études rétrospectives (MeSH).
MESH :
- effets indésirables : Immunosuppresseurs, Sirolimus, Transplantation de cellules souches hématopoïétiques.
- méthodes : Prémédication.
- prévention et contrôle : Infections à cytomégalovirus.
- sang : Sirolimus.
- usage thérapeutique : Antiviraux.
- étiologie : Infections à cytomégalovirus.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Mâle, Relation dose-effet des médicaments, Transplantation homologue, Études rétrospectives.

English descriptors

KwdEn :
- Adult (MeSH), Antiviral Agents (therapeutic use), Cytomegalovirus Infections (etiology), Cytomegalovirus Infections (prevention & control), Dose-Response Relationship, Drug (MeSH), Female (MeSH), Hematopoietic Stem Cell Transplantation (adverse effects), Humans (MeSH), Immunosuppressive Agents (adverse effects), Male (MeSH), Middle Aged (MeSH), Premedication (methods), Retrospective Studies (MeSH), Sirolimus (adverse effects), Sirolimus (blood), Transplantation, Homologous (MeSH).
MESH :
- chemical , adverse effects : Immunosuppressive Agents, Sirolimus.
- chemical , blood : Sirolimus.
- chemical , therapeutic use : Antiviral Agents.
- adverse effects : Hematopoietic Stem Cell Transplantation.
- etiology : Cytomegalovirus Infections.
- methods : Premedication.
- prevention & control : Cytomegalovirus Infections.
- Adult, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Retrospective Studies, Transplantation, Homologous.

Abstract

The current study evaluates the clinical effect of sirolimus exposure on the occurrence of cytomegalovirus (CMV) DNAemia necessitating preemptive antiviral therapy. A total of 167 consecutive recipients of reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT) who received sirolimus- and tacrolimus-based graft-versus-host disease (GVHD) prophylaxis and whose CMV serostatus was positive for donors and/or recipients were included in this multicenter retrospective study. A parametric model with consecutive sirolimus blood levels describing the time to CMV DNAemia-RAT was developed using NONMEM version 7.4. Overall, 122 of 167 patients (73%) were allografted from an unrelated donor, and the donor CMV-serostatus was negative in 51 cases (31%). Fifty-six recipients (34%) developed CMV DNAemia necessitating preemptive therapy, with a cumulative incidence of 36% at a median follow-up of 25 months. Time to CMV DNAemia necessitating preemptive therapy was best described using a Gompertz function. CMV DNAemia necessitating preemptive therapy-predicting factors were antithymocyte globulin-based conditioning regimen (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.1 to 4.1; P < .01) and sirolimus concentration (HR, .94; 95% CI, .87 to .99; P < .01). The risk of CMV DNAemia-RAT decreased by 6% for each 1 ng/mL increase in sirolimus trough concentration. In conclusion, we provide evidence on the association between sirolimus blood concentration and incidence of CMV DNAemia necessitating preemptive therapy in allo-HSCT recipients. Moreover, this study presents the first predictive model describing the time to CMV DNAemia necessitating preemptive antiviral therapy as a function of sirolimus drug concentration.

DOI: 10.1016/j.bbmt.2019.01.012
PubMed: 30639821

Affiliations:

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Le document en format XML

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<author><name sortKey="Martino, Rodrigo" sort="Martino, Rodrigo" uniqKey="Martino R" first="Rodrigo" last="Martino">Rodrigo Martino</name>
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<author><name sortKey="Pi Ana, Jose Luis" sort="Pi Ana, Jose Luis" uniqKey="Pi Ana J" first="José Luis" last="Pi Ana">José Luis Pi Ana</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Effect of Sirolimus Exposure on the Need for Preemptive Antiviral Therapy for Cytomeglovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.</title>
<author><name sortKey="Guglieri Lopez, Beatriz" sort="Guglieri Lopez, Beatriz" uniqKey="Guglieri Lopez B" first="Beatriz" last="Guglieri-Lopez">Beatriz Guglieri-Lopez</name>
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<author><name sortKey="Perez Pitarch, Alejandro" sort="Perez Pitarch, Alejandro" uniqKey="Perez Pitarch A" first="Alejandro" last="Perez-Pitarch">Alejandro Perez-Pitarch</name>
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<author><name sortKey="Garcia Cadenas, Irene" sort="Garcia Cadenas, Irene" uniqKey="Garcia Cadenas I" first="Irene" last="Garcia-Cadenas">Irene Garcia-Cadenas</name>
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<author><name sortKey="Gimenez, Estela" sort="Gimenez, Estela" uniqKey="Gimenez E" first="Estela" last="Gimenez">Estela Gimenez</name>
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<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
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<author><name sortKey="Rabella, Nuria" sort="Rabella, Nuria" uniqKey="Rabella N" first="Nuria" last="Rabella">Nuria Rabella</name>
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<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
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<author><name sortKey="Hernandez Boluda, Juan Carlos" sort="Hernandez Boluda, Juan Carlos" uniqKey="Hernandez Boluda J" first="Juan Carlos" last="Hernandez-Boluda">Juan Carlos Hernandez-Boluda</name>
<affiliation><nlm:affiliation>Department of Hematology, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia. Spain.</nlm:affiliation>
<wicri:noCountry code="subField">Valencia</wicri:noCountry>
</affiliation>
</author>
<author><name sortKey="Fox, Laura" sort="Fox, Laura" uniqKey="Fox L" first="Laura" last="Fox">Laura Fox</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Hematology, Hospital Universitari Vall D'Hebron, Barcelona. Spain.</nlm:affiliation>
<country>Espagne</country>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
<wicri:orgArea>Department of Hematology, Hospital Universitari Vall D'Hebron</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Valcarcel, David" sort="Valcarcel, David" uniqKey="Valcarcel D" first="David" last="Valcarcel">David Valcarcel</name>
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<country>Espagne</country>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
<wicri:orgArea>Department of Hematology, Hospital Universitari Vall D'Hebron</wicri:orgArea>
</affiliation>
</author>
<author><name sortKey="Esquirol, Albert" sort="Esquirol, Albert" uniqKey="Esquirol A" first="Albert" last="Esquirol">Albert Esquirol</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ferriols Lisart, Rafael" sort="Ferriols Lisart, Rafael" uniqKey="Ferriols Lisart R" first="Rafael" last="Ferriols-Lisart">Rafael Ferriols-Lisart</name>
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<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Pharmacy Department, Hospital Clínico Universitario, Valencia</wicri:regionArea>
<wicri:noRegion>Valencia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sierra, Jorge" sort="Sierra, Jorge" uniqKey="Sierra J" first="Jorge" last="Sierra">Jorge Sierra</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Solano, Carlos" sort="Solano, Carlos" uniqKey="Solano C" first="Carlos" last="Solano">Carlos Solano</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Hematology, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia. Spain; Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Hematology, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia. Spain; Department of Medicine, School of Medicine, University of Valencia, Valencia</wicri:regionArea>
<wicri:noRegion>Valencia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Navarro, David" sort="Navarro, David" uniqKey="Navarro D" first="David" last="Navarro">David Navarro</name>
<affiliation wicri:level="1"><nlm:affiliation>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain; Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain; Department of Microbiology, School of Medicine, University of Valencia, Valencia</wicri:regionArea>
<wicri:noRegion>Valencia</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Martino, Rodrigo" sort="Martino, Rodrigo" uniqKey="Martino R" first="Rodrigo" last="Martino">Rodrigo Martino</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona</wicri:regionArea>
<placeName><settlement type="city">Barcelone</settlement>
<region nuts="2" type="region">Catalogne</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Pi Ana, Jose Luis" sort="Pi Ana, Jose Luis" uniqKey="Pi Ana J" first="José Luis" last="Pi Ana">José Luis Pi Ana</name>
<affiliation wicri:level="3"><nlm:affiliation>Department of Hematology, Hospital Universitari i Politècnic la Fe, Valencia. Spain; Centro de Investigación Biomédica en Red Cáncer, Instituto Carlos III, Madrid, Spain. Electronic address: jlpinana@gmail.com.</nlm:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Hematology, Hospital Universitari i Politècnic la Fe, Valencia. Spain; Centro de Investigación Biomédica en Red Cáncer, Instituto Carlos III, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
</analytic>
<series><title level="j">Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation</title>
<idno type="eISSN">1523-6536</idno>
<imprint><date when="2019" type="published">2019</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term>
<term>Antiviral Agents (therapeutic use)</term>
<term>Cytomegalovirus Infections (etiology)</term>
<term>Cytomegalovirus Infections (prevention & control)</term>
<term>Dose-Response Relationship, Drug (MeSH)</term>
<term>Female (MeSH)</term>
<term>Hematopoietic Stem Cell Transplantation (adverse effects)</term>
<term>Humans (MeSH)</term>
<term>Immunosuppressive Agents (adverse effects)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Premedication (methods)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Sirolimus (adverse effects)</term>
<term>Sirolimus (blood)</term>
<term>Transplantation, Homologous (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Antiviraux (usage thérapeutique)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Immunosuppresseurs (effets indésirables)</term>
<term>Infections à cytomégalovirus (prévention et contrôle)</term>
<term>Infections à cytomégalovirus (étiologie)</term>
<term>Mâle (MeSH)</term>
<term>Prémédication (méthodes)</term>
<term>Relation dose-effet des médicaments (MeSH)</term>
<term>Sirolimus (effets indésirables)</term>
<term>Sirolimus (sang)</term>
<term>Transplantation de cellules souches hématopoïétiques (effets indésirables)</term>
<term>Transplantation homologue (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Immunosuppressive Agents</term>
<term>Sirolimus</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Sirolimus</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Hematopoietic Stem Cell Transplantation</term>
</keywords>
<keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Immunosuppresseurs</term>
<term>Sirolimus</term>
<term>Transplantation de cellules souches hématopoïétiques</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cytomegalovirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Premedication</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Prémédication</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Cytomegalovirus Infections</term>
</keywords>
<keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Infections à cytomégalovirus</term>
</keywords>
<keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Sirolimus</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Infections à cytomégalovirus</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Dose-Response Relationship, Drug</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
<term>Transplantation, Homologous</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mâle</term>
<term>Relation dose-effet des médicaments</term>
<term>Transplantation homologue</term>
<term>Études rétrospectives</term>
</keywords>
</textClass>
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<front><div type="abstract" xml:lang="en">The current study evaluates the clinical effect of sirolimus exposure on the occurrence of cytomegalovirus (CMV) DNAemia necessitating preemptive antiviral therapy. A total of 167 consecutive recipients of reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT) who received sirolimus- and tacrolimus-based graft-versus-host disease (GVHD) prophylaxis and whose CMV serostatus was positive for donors and/or recipients were included in this multicenter retrospective study. A parametric model with consecutive sirolimus blood levels describing the time to CMV DNAemia-RAT was developed using NONMEM version 7.4. Overall, 122 of 167 patients (73%) were allografted from an unrelated donor, and the donor CMV-serostatus was negative in 51 cases (31%). Fifty-six recipients (34%) developed CMV DNAemia necessitating preemptive therapy, with a cumulative incidence of 36% at a median follow-up of 25 months. Time to CMV DNAemia necessitating preemptive therapy was best described using a Gompertz function. CMV DNAemia necessitating preemptive therapy-predicting factors were antithymocyte globulin-based conditioning regimen (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.1 to 4.1; P < .01) and sirolimus concentration (HR, .94; 95% CI, .87 to .99; P < .01). The risk of CMV DNAemia-RAT decreased by 6% for each 1 ng/mL increase in sirolimus trough concentration. In conclusion, we provide evidence on the association between sirolimus blood concentration and incidence of CMV DNAemia necessitating preemptive therapy in allo-HSCT recipients. Moreover, this study presents the first predictive model describing the time to CMV DNAemia necessitating preemptive antiviral therapy as a function of sirolimus drug concentration.</div>
</front>
</TEI>
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<DateCompleted><Year>2020</Year>
<Month>03</Month>
<Day>20</Day>
</DateCompleted>
<DateRevised><Year>2020</Year>
<Month>03</Month>
<Day>20</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1523-6536</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>25</Volume>
<Issue>5</Issue>
<PubDate><Year>2019</Year>
<Month>05</Month>
</PubDate>
</JournalIssue>
<Title>Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation</Title>
<ISOAbbreviation>Biol Blood Marrow Transplant</ISOAbbreviation>
</Journal>
<ArticleTitle>Effect of Sirolimus Exposure on the Need for Preemptive Antiviral Therapy for Cytomeglovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.</ArticleTitle>
<Pagination><MedlinePgn>1022-1030</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S1083-8791(19)30027-8</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.bbmt.2019.01.012</ELocationID>
<Abstract><AbstractText>The current study evaluates the clinical effect of sirolimus exposure on the occurrence of cytomegalovirus (CMV) DNAemia necessitating preemptive antiviral therapy. A total of 167 consecutive recipients of reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (allo-HSCT) who received sirolimus- and tacrolimus-based graft-versus-host disease (GVHD) prophylaxis and whose CMV serostatus was positive for donors and/or recipients were included in this multicenter retrospective study. A parametric model with consecutive sirolimus blood levels describing the time to CMV DNAemia-RAT was developed using NONMEM version 7.4. Overall, 122 of 167 patients (73%) were allografted from an unrelated donor, and the donor CMV-serostatus was negative in 51 cases (31%). Fifty-six recipients (34%) developed CMV DNAemia necessitating preemptive therapy, with a cumulative incidence of 36% at a median follow-up of 25 months. Time to CMV DNAemia necessitating preemptive therapy was best described using a Gompertz function. CMV DNAemia necessitating preemptive therapy-predicting factors were antithymocyte globulin-based conditioning regimen (hazard ratio [HR], 2.2; 95% confidence interval [CI], 1.1 to 4.1; P < .01) and sirolimus concentration (HR, .94; 95% CI, .87 to .99; P < .01). The risk of CMV DNAemia-RAT decreased by 6% for each 1 ng/mL increase in sirolimus trough concentration. In conclusion, we provide evidence on the association between sirolimus blood concentration and incidence of CMV DNAemia necessitating preemptive therapy in allo-HSCT recipients. Moreover, this study presents the first predictive model describing the time to CMV DNAemia necessitating preemptive antiviral therapy as a function of sirolimus drug concentration.</AbstractText>
<CopyrightInformation>Copyright © 2019 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Guglieri-Lopez</LastName>
<ForeName>Beatriz</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Pharmacy Department, Hospital Universitario Doctor Peset, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Perez-Pitarch</LastName>
<ForeName>Alejandro</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Pharmacy Department, Hospital Clínico Universitario, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Garcia-Cadenas</LastName>
<ForeName>Irene</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gimenez</LastName>
<ForeName>Estela</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Barba</LastName>
<ForeName>Pere</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital Universitari Vall D'Hebron, Barcelona. Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rabella</LastName>
<ForeName>Nuria</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Department of Microbiology, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hernandez-Boluda</LastName>
<ForeName>Juan Carlos</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia. Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fox</LastName>
<ForeName>Laura</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital Universitari Vall D'Hebron, Barcelona. Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Valcarcel</LastName>
<ForeName>David</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital Universitari Vall D'Hebron, Barcelona. Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Esquirol</LastName>
<ForeName>Albert</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ferriols-Lisart</LastName>
<ForeName>Rafael</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Pharmacy Department, Hospital Clínico Universitario, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sierra</LastName>
<ForeName>Jorge</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Solano</LastName>
<ForeName>Carlos</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, INCLIVA Research Institute, Hospital Clínico Universitario, Valencia. Spain; Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Navarro</LastName>
<ForeName>David</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain; Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Martino</LastName>
<ForeName>Rodrigo</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Piñana</LastName>
<ForeName>José Luis</ForeName>
<Initials>JL</Initials>
<AffiliationInfo><Affiliation>Department of Hematology, Hospital Universitari i Politècnic la Fe, Valencia. Spain; Centro de Investigación Biomédica en Red Cáncer, Instituto Carlos III, Madrid, Spain. Electronic address: jlpinana@gmail.com.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2019</Year>
<Month>01</Month>
<Day>10</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Biol Blood Marrow Transplant</MedlineTA>
<NlmUniqueID>9600628</NlmUniqueID>
<ISSNLinking>1083-8791</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance>
</Chemical>
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<NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance>
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</Chemical>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
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<QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004305" MajorTopicYN="N">Dose-Response Relationship, Drug</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018380" MajorTopicYN="N">Hematopoietic Stem Cell Transplantation</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007166" MajorTopicYN="N">Immunosuppressive Agents</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
</MeshHeading>
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</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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</MeshHeading>
<MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D020123" MajorTopicYN="N">Sirolimus</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
<QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014184" MajorTopicYN="N">Transplantation, Homologous</DescriptorName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Allogeneic hematopoietic stem cells transplantation</Keyword>
<Keyword MajorTopicYN="Y">Cytomegalovirus DNAemia</Keyword>
<Keyword MajorTopicYN="Y">Cytomegalovirus disease</Keyword>
<Keyword MajorTopicYN="Y">Cytomegalovirus infection</Keyword>
<Keyword MajorTopicYN="Y">Mechanistic target of rapamycin inhibitor</Keyword>
<Keyword MajorTopicYN="Y">PK/PD</Keyword>
<Keyword MajorTopicYN="Y">Preemptive antiviral therapy</Keyword>
<Keyword MajorTopicYN="Y">Quantitative PCR</Keyword>
<Keyword MajorTopicYN="Y">Sirolimus</Keyword>
<Keyword MajorTopicYN="Y">Sirolimus exposure</Keyword>
<Keyword MajorTopicYN="Y">Time-to-event analysis</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year>
<Month>10</Month>
<Day>09</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2019</Year>
<Month>01</Month>
<Day>04</Day>
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<Month>1</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="medline"><Year>2020</Year>
<Month>3</Month>
<Day>21</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<affiliations><list><country><li>Espagne</li>
</country>
<region><li>Catalogne</li>
<li>Communauté de Madrid</li>
</region>
<settlement><li>Barcelone</li>
<li>Madrid</li>
</settlement>
<orgName><li>Université autonome de Barcelone</li>
</orgName>
</list>
<tree><noCountry><name sortKey="Hernandez Boluda, Juan Carlos" sort="Hernandez Boluda, Juan Carlos" uniqKey="Hernandez Boluda J" first="Juan Carlos" last="Hernandez-Boluda">Juan Carlos Hernandez-Boluda</name>
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<country name="Espagne"><noRegion><name sortKey="Guglieri Lopez, Beatriz" sort="Guglieri Lopez, Beatriz" uniqKey="Guglieri Lopez B" first="Beatriz" last="Guglieri-Lopez">Beatriz Guglieri-Lopez</name>
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<name sortKey="Barba, Pere" sort="Barba, Pere" uniqKey="Barba P" first="Pere" last="Barba">Pere Barba</name>
<name sortKey="Esquirol, Albert" sort="Esquirol, Albert" uniqKey="Esquirol A" first="Albert" last="Esquirol">Albert Esquirol</name>
<name sortKey="Ferriols Lisart, Rafael" sort="Ferriols Lisart, Rafael" uniqKey="Ferriols Lisart R" first="Rafael" last="Ferriols-Lisart">Rafael Ferriols-Lisart</name>
<name sortKey="Fox, Laura" sort="Fox, Laura" uniqKey="Fox L" first="Laura" last="Fox">Laura Fox</name>
<name sortKey="Garcia Cadenas, Irene" sort="Garcia Cadenas, Irene" uniqKey="Garcia Cadenas I" first="Irene" last="Garcia-Cadenas">Irene Garcia-Cadenas</name>
<name sortKey="Gimenez, Estela" sort="Gimenez, Estela" uniqKey="Gimenez E" first="Estela" last="Gimenez">Estela Gimenez</name>
<name sortKey="Martino, Rodrigo" sort="Martino, Rodrigo" uniqKey="Martino R" first="Rodrigo" last="Martino">Rodrigo Martino</name>
<name sortKey="Navarro, David" sort="Navarro, David" uniqKey="Navarro D" first="David" last="Navarro">David Navarro</name>
<name sortKey="Perez Pitarch, Alejandro" sort="Perez Pitarch, Alejandro" uniqKey="Perez Pitarch A" first="Alejandro" last="Perez-Pitarch">Alejandro Perez-Pitarch</name>
<name sortKey="Pi Ana, Jose Luis" sort="Pi Ana, Jose Luis" uniqKey="Pi Ana J" first="José Luis" last="Pi Ana">José Luis Pi Ana</name>
<name sortKey="Rabella, Nuria" sort="Rabella, Nuria" uniqKey="Rabella N" first="Nuria" last="Rabella">Nuria Rabella</name>
<name sortKey="Sierra, Jorge" sort="Sierra, Jorge" uniqKey="Sierra J" first="Jorge" last="Sierra">Jorge Sierra</name>
<name sortKey="Solano, Carlos" sort="Solano, Carlos" uniqKey="Solano C" first="Carlos" last="Solano">Carlos Solano</name>
<name sortKey="Valcarcel, David" sort="Valcarcel, David" uniqKey="Valcarcel D" first="David" last="Valcarcel">David Valcarcel</name>
</country>
</tree>
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Effect of Sirolimus Exposure on the Need for Preemptive Antiviral Therapy for Cytomeglovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.

Effect of Sirolimus Exposure on the Need for Preemptive Antiviral Therapy for Cytomeglovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation.

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