Sirolimus exposure and the occurrence of cytomegalovirus DNAemia after allogeneic hematopoietic stem cell transplantation.
Identifieur interne : 000492 ( Main/Exploration ); précédent : 000491; suivant : 000493Sirolimus exposure and the occurrence of cytomegalovirus DNAemia after allogeneic hematopoietic stem cell transplantation.
Auteurs : José Luis Pi Ana [Espagne] ; Alejandro Perez-Pitarch [Espagne] ; Beatriz Guglieri-Lopez [Espagne] ; Estela Giménez [Espagne] ; Juan Carlos Hernandez-Boluda [Espagne] ; María José Terol [Espagne] ; Rafael Ferriols-Lisart [Espagne] ; Carlos Solano [Espagne] ; David Navarro [Espagne]Source :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [ 1600-6143 ] ; 2018.
Descripteurs français
- KwdFr :
- ADN viral (génétique), Adulte (MeSH), Adulte d'âge moyen (MeSH), Cytomegalovirus (effets des médicaments et des substances chimiques), Cytomegalovirus (génétique), Cytomegalovirus (isolement et purification), Espagne (épidémiologie), Facteurs de risque (MeSH), Femelle (MeSH), Humains (MeSH), Immunosuppresseurs (usage thérapeutique), Incidence (MeSH), Infections à cytomégalovirus (microbiologie), Infections à cytomégalovirus (traitement médicamenteux), Infections à cytomégalovirus (épidémiologie), Mâle (MeSH), Pronostic (MeSH), Receveurs de transplantation (MeSH), Sirolimus (usage thérapeutique), Sujet âgé (MeSH), Transplantation de cellules souches hématopoïétiques (effets indésirables), Transplantation homologue (MeSH), Virémie (microbiologie), Virémie (traitement médicamenteux), Virémie (épidémiologie), Études de suivi (MeSH).
- MESH :
- effets des médicaments et des substances chimiques : Cytomegalovirus.
- effets indésirables : Transplantation de cellules souches hématopoïétiques.
- génétique : ADN viral, Cytomegalovirus.
- isolement et purification : Cytomegalovirus.
- microbiologie : Infections à cytomégalovirus, Virémie.
- traitement médicamenteux : Infections à cytomégalovirus, Virémie.
- usage thérapeutique : Immunosuppresseurs, Sirolimus.
- épidémiologie : Espagne, Infections à cytomégalovirus, Virémie.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Humains, Incidence, Mâle, Pronostic, Receveurs de transplantation, Sujet âgé, Transplantation homologue, Études de suivi.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Cytomegalovirus (drug effects), Cytomegalovirus (genetics), Cytomegalovirus (isolation & purification), Cytomegalovirus Infections (drug therapy), Cytomegalovirus Infections (epidemiology), Cytomegalovirus Infections (microbiology), DNA, Viral (genetics), Female (MeSH), Follow-Up Studies (MeSH), Hematopoietic Stem Cell Transplantation (adverse effects), Humans (MeSH), Immunosuppressive Agents (therapeutic use), Incidence (MeSH), Male (MeSH), Middle Aged (MeSH), Prognosis (MeSH), Risk Factors (MeSH), Sirolimus (therapeutic use), Spain (epidemiology), Transplant Recipients (MeSH), Transplantation, Homologous (MeSH), Viremia (drug therapy), Viremia (epidemiology), Viremia (microbiology).
- MESH :
- chemical , genetics : DNA, Viral.
- geographic , epidemiology : Spain.
- adverse effects : Hematopoietic Stem Cell Transplantation.
- drug effects : Cytomegalovirus.
- drug therapy : Cytomegalovirus Infections, Viremia.
- epidemiology : Cytomegalovirus Infections, Viremia.
- genetics : Cytomegalovirus.
- isolation & purification : Cytomegalovirus.
- microbiology : Cytomegalovirus Infections, Viremia.
- chemical , therapeutic use : Immunosuppressive Agents, Sirolimus.
- Adult, Aged, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Prognosis, Risk Factors, Transplant Recipients, Transplantation, Homologous.
Abstract
Sirolimus appears to protect against cytomegalovirus (CMV) in organ transplant recipients. The effect of this drug in allogeneic hematopoietic stem cell transplantation recipients remains unexplored. By means of multivariate continuous-time Markov model analyses, we identified 3 independent covariates that significantly impacted the risk of CMV DNAemia: recipient/donor CMV serostatus, tacrolimus exposure, and sirolimus exposure. CMV-seropositive recipients with CMV-seronegative donors had a significantly higher probability of having detectable CMV DNAemia. Increasing the tacrolimus trough concentration from 0 to 16 ng/mL increased the probability of patients having detectable CMV DNAemia by 40% (from 40% to 80%), whereas this probability decreased by 25% (from 40% to 15%) when trough concentrations of sirolimus increased from 0 to 16 ng/mL. Sensitivity analysis showed that sirolimus exposure between 0 and 6 ng/mL has no or negligible effect on CMV DNAemia, but levels >8 ng/mL significantly decreased the number of detectable CMV DNAemia cases (the risk ratios decreased from 0.68 to 0.21 when whole blood sirolimus concentrations changed from 8 to 18 ng/mL, P < .01). In conclusion, we used a pharmacometric statistical tool to provide the first clinical evidence that fewer CMV DNAemia events become detectable as sirolimus exposure increases.
DOI: 10.1111/ajt.14754
PubMed: 29603596
Affiliations:
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sortKey="Guglieri Lopez, Beatriz" sort="Guglieri Lopez, Beatriz" uniqKey="Guglieri Lopez B" first="Beatriz" last="Guglieri-Lopez">Beatriz Guglieri-Lopez</name><affiliation wicri:level="1"><nlm:affiliation>Pharmacy Department, Hospital Universitario Doctor Peset, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Pharmacy Department, Hospital Universitario Doctor Peset, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Gimenez, Estela" sort="Gimenez, Estela" uniqKey="Gimenez E" first="Estela" last="Giménez">Estela Giménez</name><affiliation wicri:level="1"><nlm:affiliation>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Microbiology Service, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><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 wicri:level="1"><nlm:affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Terol, Maria Jose" sort="Terol, Maria Jose" uniqKey="Terol M" first="María José" last="Terol">María José Terol</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of 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xml:lang="fr">Espagne</country><wicri:regionArea>Department of Hematology, Hospital Universitari i Politècnic la Fe, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>CIBERONC, Instituto Carlos III, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBERONC, Instituto Carlos III, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Perez Pitarch, Alejandro" sort="Perez Pitarch, Alejandro" uniqKey="Perez Pitarch A" first="Alejandro" last="Perez-Pitarch">Alejandro Perez-Pitarch</name><affiliation wicri:level="1"><nlm:affiliation>Pharmacy Department, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><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="Guglieri Lopez, Beatriz" sort="Guglieri Lopez, Beatriz" uniqKey="Guglieri Lopez B" first="Beatriz" last="Guglieri-Lopez">Beatriz Guglieri-Lopez</name><affiliation wicri:level="1"><nlm:affiliation>Pharmacy Department, Hospital Universitario Doctor Peset, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Pharmacy Department, Hospital Universitario Doctor Peset, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Gimenez, Estela" sort="Gimenez, Estela" uniqKey="Gimenez E" first="Estela" last="Giménez">Estela Giménez</name><affiliation wicri:level="1"><nlm:affiliation>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Microbiology Service, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><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 wicri:level="1"><nlm:affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Terol, Maria Jose" sort="Terol, Maria Jose" uniqKey="Terol M" first="María José" last="Terol">María José Terol</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></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><affiliation wicri:level="1"><nlm:affiliation>Pharmacy Department, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><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="Solano, Carlos" sort="Solano, Carlos" uniqKey="Solano C" first="Carlos" last="Solano">Carlos Solano</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>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.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Microbiology Service, Hospital Clínico Universitario, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:affiliation>Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Microbiology, School of Medicine, University of Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author></analytic><series><title level="j">American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons</title><idno type="eISSN">1600-6143</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Cytomegalovirus (drug effects)</term><term>Cytomegalovirus (genetics)</term><term>Cytomegalovirus (isolation & purification)</term><term>Cytomegalovirus Infections (drug therapy)</term><term>Cytomegalovirus Infections (epidemiology)</term><term>Cytomegalovirus Infections (microbiology)</term><term>DNA, Viral (genetics)</term><term>Female (MeSH)</term><term>Follow-Up Studies (MeSH)</term><term>Hematopoietic Stem Cell Transplantation (adverse effects)</term><term>Humans (MeSH)</term><term>Immunosuppressive Agents (therapeutic use)</term><term>Incidence (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prognosis (MeSH)</term><term>Risk Factors (MeSH)</term><term>Sirolimus (therapeutic use)</term><term>Spain (epidemiology)</term><term>Transplant Recipients (MeSH)</term><term>Transplantation, Homologous (MeSH)</term><term>Viremia (drug therapy)</term><term>Viremia (epidemiology)</term><term>Viremia (microbiology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>ADN viral (génétique)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Cytomegalovirus (effets des médicaments et des substances chimiques)</term><term>Cytomegalovirus (génétique)</term><term>Cytomegalovirus (isolement et purification)</term><term>Espagne (épidémiologie)</term><term>Facteurs de risque (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Immunosuppresseurs (usage thérapeutique)</term><term>Incidence (MeSH)</term><term>Infections à cytomégalovirus (microbiologie)</term><term>Infections à cytomégalovirus (traitement médicamenteux)</term><term>Infections à cytomégalovirus (épidémiologie)</term><term>Mâle (MeSH)</term><term>Pronostic (MeSH)</term><term>Receveurs de transplantation (MeSH)</term><term>Sirolimus (usage thérapeutique)</term><term>Sujet âgé (MeSH)</term><term>Transplantation de cellules souches hématopoïétiques (effets indésirables)</term><term>Transplantation homologue (MeSH)</term><term>Virémie (microbiologie)</term><term>Virémie (traitement médicamenteux)</term><term>Virémie (épidémiologie)</term><term>Études de suivi (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="genetics" xml:lang="en"><term>DNA, Viral</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Hematopoietic Stem Cell Transplantation</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Cytomegalovirus</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Cytomegalovirus Infections</term><term>Viremia</term></keywords><keywords scheme="MESH" qualifier="effets des médicaments et des substances chimiques" xml:lang="fr"><term>Cytomegalovirus</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Transplantation de cellules souches hématopoïétiques</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cytomegalovirus Infections</term><term>Viremia</term></keywords><keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Cytomegalovirus</term></keywords><keywords scheme="MESH" qualifier="génétique" xml:lang="fr"><term>ADN viral</term><term>Cytomegalovirus</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Cytomegalovirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Cytomegalovirus</term></keywords><keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Infections à cytomégalovirus</term><term>Virémie</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Cytomegalovirus Infections</term><term>Viremia</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Immunosuppressive Agents</term><term>Sirolimus</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à cytomégalovirus</term><term>Virémie</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Immunosuppresseurs</term><term>Sirolimus</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Espagne</term><term>Infections à cytomégalovirus</term><term>Virémie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Incidence</term><term>Male</term><term>Middle Aged</term><term>Prognosis</term><term>Risk Factors</term><term>Transplant Recipients</term><term>Transplantation, Homologous</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Incidence</term><term>Mâle</term><term>Pronostic</term><term>Receveurs de transplantation</term><term>Sujet âgé</term><term>Transplantation homologue</term><term>Études de suivi</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Sirolimus appears to protect against cytomegalovirus (CMV) in organ transplant recipients. The effect of this drug in allogeneic hematopoietic stem cell transplantation recipients remains unexplored. By means of multivariate continuous-time Markov model analyses, we identified 3 independent covariates that significantly impacted the risk of CMV DNAemia: recipient/donor CMV serostatus, tacrolimus exposure, and sirolimus exposure. CMV-seropositive recipients with CMV-seronegative donors had a significantly higher probability of having detectable CMV DNAemia. Increasing the tacrolimus trough concentration from 0 to 16 ng/mL increased the probability of patients having detectable CMV DNAemia by 40% (from 40% to 80%), whereas this probability decreased by 25% (from 40% to 15%) when trough concentrations of sirolimus increased from 0 to 16 ng/mL. Sensitivity analysis showed that sirolimus exposure between 0 and 6 ng/mL has no or negligible effect on CMV DNAemia, but levels >8 ng/mL significantly decreased the number of detectable CMV DNAemia cases (the risk ratios decreased from 0.68 to 0.21 when whole blood sirolimus concentrations changed from 8 to 18 ng/mL, P < .01). In conclusion, we used a pharmacometric statistical tool to provide the first clinical evidence that fewer CMV DNAemia events become detectable as sirolimus exposure increases.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29603596</PMID><DateCompleted><Year>2019</Year><Month>12</Month><Day>06</Day></DateCompleted><DateRevised><Year>2019</Year><Month>12</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1600-6143</ISSN><JournalIssue CitedMedium="Internet"><Volume>18</Volume><Issue>12</Issue><PubDate><Year>2018</Year><Month>12</Month></PubDate></JournalIssue><Title>American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons</Title><ISOAbbreviation>Am J Transplant</ISOAbbreviation></Journal><ArticleTitle>Sirolimus exposure and the occurrence of cytomegalovirus DNAemia after allogeneic hematopoietic stem cell transplantation.</ArticleTitle><Pagination><MedlinePgn>2885-2894</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/ajt.14754</ELocationID><Abstract><AbstractText>Sirolimus appears to protect against cytomegalovirus (CMV) in organ transplant recipients. The effect of this drug in allogeneic hematopoietic stem cell transplantation recipients remains unexplored. By means of multivariate continuous-time Markov model analyses, we identified 3 independent covariates that significantly impacted the risk of CMV DNAemia: recipient/donor CMV serostatus, tacrolimus exposure, and sirolimus exposure. CMV-seropositive recipients with CMV-seronegative donors had a significantly higher probability of having detectable CMV DNAemia. Increasing the tacrolimus trough concentration from 0 to 16 ng/mL increased the probability of patients having detectable CMV DNAemia by 40% (from 40% to 80%), whereas this probability decreased by 25% (from 40% to 15%) when trough concentrations of sirolimus increased from 0 to 16 ng/mL. Sensitivity analysis showed that sirolimus exposure between 0 and 6 ng/mL has no or negligible effect on CMV DNAemia, but levels >8 ng/mL significantly decreased the number of detectable CMV DNAemia cases (the risk ratios decreased from 0.68 to 0.21 when whole blood sirolimus concentrations changed from 8 to 18 ng/mL, P < .01). In conclusion, we used a pharmacometric statistical tool to provide the first clinical evidence that fewer CMV DNAemia events become detectable as sirolimus exposure increases.</AbstractText><CopyrightInformation>© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Piñana</LastName><ForeName>José Luis</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Hematology, Hospital Universitari i Politècnic la Fe, Valencia, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIBERONC, Instituto Carlos III, Madrid, 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>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>Giménez</LastName><ForeName>Estela</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Microbiology Service, Hospital Clínico Universitario, Valencia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hernandez-Boluda</LastName><ForeName>Juan Carlos</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Terol</LastName><ForeName>María José</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, 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>Solano</LastName><ForeName>Carlos</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Hematology, Fundación de investigación, INCLIVA, Hospital Clínico Universitario, Valencia, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>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.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>04</Month><Day>24</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Am J Transplant</MedlineTA><NlmUniqueID>100968638</NlmUniqueID><ISSNLinking>1600-6135</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004279">DNA, Viral</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007166">Immunosuppressive Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>W36ZG6FT64</RegistryNumber><NameOfSubstance UI="D020123">Sirolimus</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003587" MajorTopicYN="N">Cytomegalovirus</DescriptorName><QualifierName UI="Q000187" MajorTopicYN="Y">drug effects</QualifierName><QualifierName UI="Q000235" MajorTopicYN="Y">genetics</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003586" MajorTopicYN="N">Cytomegalovirus Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004279" MajorTopicYN="N">DNA, Viral</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="Y">genetics</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</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="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015994" MajorTopicYN="N">Incidence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020123" MajorTopicYN="N">Sirolimus</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D066027" MajorTopicYN="N">Transplant Recipients</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014184" MajorTopicYN="N">Transplantation, Homologous</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014766" MajorTopicYN="N">Viremia</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000382" MajorTopicYN="N">microbiology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">antibiotic: antiviral</Keyword><Keyword MajorTopicYN="Y">basic (laboratory) research/science</Keyword><Keyword MajorTopicYN="Y">bone marrow/hematopoietic stem cell transplantation</Keyword><Keyword MajorTopicYN="Y">clinical research/practice</Keyword><Keyword MajorTopicYN="Y">immunosuppressant-calcineurin inhibitor: tacrolimus</Keyword><Keyword MajorTopicYN="Y">immunosuppressant-mechanistic target of rapamycin: sirolimus</Keyword><Keyword MajorTopicYN="Y">infection and infectious agents-viral: cytomegalovirus (CMV)</Keyword><Keyword MajorTopicYN="Y">infectious disease</Keyword><Keyword MajorTopicYN="Y">pharmacokinetics/pharmacodynamics</Keyword><Keyword MajorTopicYN="Y">pharmacology</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>10</Month><Day>13</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2018</Year><Month>03</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>03</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>12</Month><Day>18</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>4</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29603596</ArticleId><ArticleId IdType="doi">10.1111/ajt.14754</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Espagne</li></country><region><li>Communauté de Madrid</li></region><settlement><li>Madrid</li></settlement></list><tree><country name="Espagne"><noRegion><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></noRegion><name sortKey="Ferriols Lisart, Rafael" sort="Ferriols Lisart, Rafael" uniqKey="Ferriols Lisart R" first="Rafael" last="Ferriols-Lisart">Rafael Ferriols-Lisart</name><name sortKey="Gimenez, Estela" sort="Gimenez, Estela" uniqKey="Gimenez E" first="Estela" last="Giménez">Estela Giménez</name><name sortKey="Guglieri Lopez, Beatriz" sort="Guglieri Lopez, Beatriz" uniqKey="Guglieri Lopez B" first="Beatriz" last="Guglieri-Lopez">Beatriz Guglieri-Lopez</name><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><name sortKey="Navarro, David" sort="Navarro, David" uniqKey="Navarro D" first="David" last="Navarro">David Navarro</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="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="Solano, Carlos" sort="Solano, Carlos" uniqKey="Solano C" first="Carlos" last="Solano">Carlos Solano</name><name sortKey="Solano, Carlos" sort="Solano, Carlos" uniqKey="Solano C" first="Carlos" last="Solano">Carlos Solano</name><name sortKey="Terol, Maria Jose" sort="Terol, Maria Jose" uniqKey="Terol M" first="María José" last="Terol">María José Terol</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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