07528nas a2200253   4500008004500000022001400045245016600059210006900225260000900294300000600303490000700309520673300316653002707049653002207076653000807098653001507106653003207121653000907153100001507162700001707177700001707194700001807211856004507229       2010                        Engldsh    a0268-336900aCMV central nervous system disease in stem-cell transplant recipients: an increasing complication of drug-resistant CMV infection and protracted immunodeficiency0 aCMV central nervous system disease in stemcell transplant recipi  cJune  a70 v453 a: We report on two patients with no active GVHD and on moderate doses of immunosuppressive drugs who unexpectedly developed fatal CMV meningoencephalitis after umbilical cord blood transplantation. A review of these two cases along with nine other cases of CMV central nervous system (CNS) disease after allogeneic SCT that were mostly reported within the last 8 years suggests that this severe complication of CMV infection may be increasing. CMV CNS disease after allogeneic SCT is a late-onset disease (median time of onset, 210 days) and is usually manifested as encephalitis in the absence of other sites of CMV disease. The development of CMV CNS disease is associated with risk factors (T-cell depletion, anti-thymocyte globulin, umbilical cord blood transplantation) that cause severe and protracted T-cell immunodeficiency (8 of 11 cases), a history of recurrent CMV viremia treated with multiple courses of preemptive ganciclovir or foscarnet therapy (11 of 11 cases), and ganciclovir-resistant CMV infection (11 of 11 cases). Despite therapy with a combination of antiviral drugs (ganciclovir, foscarnet and cidofovir), mortality is high (10 of 11 cases). 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J Infect Dis 2008; 197: 1631-1633.10acentral nervous system10aClinical Medicine10aCMV10acord blood10aLife & Biomedical Sciences.10aSCT.1 aReddy, S M1 aWinston, D J1 aTerrito, M C1 aSchiller, G J  uhttp://613633.bywedr.asia/reference/1846