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document
Use of a DNAemia cut-off for monitoring human cytomegalovirus infection reduces the number of preemptively treated children and young adults receiving hematopoietic stem-cell transplantation compared with qualitative pp65 antigenemia . We performed a randomized trial comparing the use of quantitative DNAemia versus positive antigenemia for starting preemptive antihuman cytomegalovirus ( HCMV ) therapy in hematopoietic stem-cell transplantation ( HSCT ) recipients . In the DNAemia arm , antiviral therapy was initiated on reaching a DNAemia cut-off of 10 000 DNA copies/mL of whole blood , whereas in the antigenemia arm , therapy was started in the presence of a positive antigenemia . The aim of the study was to compare the number of patients treated in the 2 arms . On the whole , 178 patients ( 89 in each arm ) , receiving unmanipulated HSCT from either a relative or an unrelated donor , completed the study . Although the incidence of HCMV infection was comparable in DNAemia and antigenemia arms ( 34 % vs 42 % , respectively , P = .259 ) , the number of patients treated was significantly lower in the DNAemia arm ( 18 % vs 31 % , P = .026 ) . No patient developed HCMV disease . The use of a DNAemia cut-off avoids unnecessary antiviral treatment .
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Intervention_Physical
DNAemia cut-off
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Intervention_Pharmacological
qualitative pp65 antigenemia
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Intervention_Pharmacological
quantitative DNAemia
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Intervention_Pharmacological
positive antigenemia
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Intervention_Pharmacological
DNAemia
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Intervention_Pharmacological
antiviral therapy
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Intervention_Physical
DNAemia cut-off
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Intervention_Pharmacological
positive antigenemia
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Intervention_Physical
unmanipulated HSCT
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Intervention_Physical
DNAemia
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Intervention_Pharmacological
DNAemia cut-off
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Intervention_Pharmacological
antiviral treatment
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Outcome_Other
number of preemptively treated children
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Outcome_Physical
HCMV infection
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Outcome_Other
number of patients treated
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Outcome_Physical
HCMV disease