الفهرس 
Hematopoietic stem cell transplantationOnly 14 pages are availabe for public view
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Abstract
The present study aimed to evaluate the impact of cytomegalovirus (CMV) infection or reactivation on the clinical outcome regarding OS, RI, DFS, mortality rates and relation to GVHD after peripheral blood stem cell (PBSCs) transplantation from a fully matching sibling donor (MSD) in different hematological malignancies. 51 patients who were attendant of Bone Marrow Transplantation Center of Nasser Institute, were followed up for 2 years from transplant date and at the end of follow up period they were grouped into two groups: group I: 9 patients with CMV reactivation. group II: 42 patients without CMV reactivation. Inclusion criteria: • Adult patients age between 15 and 60 years. • Diagnosed of having hematological malignancy • Fully HLA matched sibling donor. • Peripheral blood as source of stem cells. • Eligible for transplant. Exclusion criteria: • Age below 15 and above 60 years. • Diseases other than malignant. • Non sibling donor. • Any source of stem cells other than peripheral blood. • Patients ineligible for transplant. All patients included in the study were subjected to the following: ❖ Full history taking and complete clinical examination with grading of the patient performance status according to ECOG scale. ❖ Laboratory investigations including: Complete blood count, blood group, coagulation screening, bone marrow aspiration and biopsy, viral marker screening, toxoplasmosis serology, renal and liver function tests, electrolytes, random blood glucose, immunology assay, pregnancy test for females and CMV serology with CMV PCR if serology was positive. ❖ Imaging: Echocardiography, Chest X ray, ECG, computerized tomography of chest and sinuses. All donors, after identification of HLA matched sibling, were subjected to pre-transplantation evaluation including the same hematological, biochemical, virology screen and echocardiography, in addition to bone marrow aspiration and cytogenetic study. Typical target yield was 2 to 5 x 106 / Kg CD34+ cells. Summary of transplant process: - All patients were isolated in single rooms with laminar airflow with strict disinfection measures and prophylactic antimicrobials with tendency to upgrade according to degree of infection then received the conditioning regimen consisting of either fludarabine-cyclophosphamide or busulfancyclophosphamide fludarabine-melphalan or busulfan -melphalan with graft-Verus-host-disease prophylaxis of methotrexate/ cyclosporin-A or mecophenolate/cyclosporine-A. - Five days of subcutaneous granulocyte-colony stimulating factor (G – CSF) were used for stem cells mobilization from the donors then peripheral blood stem cells were separated through leukapheresis. - Oral cyclosporine for GVHD prophylaxis and prophylactic antimicrobial will be continued for a minimum of 90 days post transplantation. The results obtained from this work tabulated and then analyzed.