{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:35:04Z","timestamp":1760240104909,"version":"build-2065373602"},"reference-count":50,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T00:00:00Z","timestamp":1552953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Unlike allogeneic transplant, autologous stem cell transplantation (ASCT) represents a procedure with a low-risk of cytomegalovirus (CMV) symptomatic reactivation-infection\/end-organ disease (CMV complications) and invasive fungal disease (IFD). However, novel drugs for the treatment of lymphoproliferative malignancies could cause an increase of such opportunistic infections, even after ASCT. To the best of our knowledge, there are no published data demonstrating an association between CMV and IFD in the autologous setting, while this association has been widely reported in allogeneic transplantation. We have reviewed our series of 347 ASCT in myeloma and lymphoma patients performed over a period of 14 years with the aim of investigating the descriptive and analytical epidemiology of bacterial, CMV and IFD complications, focusing on the association between CMV and IFD. Patients with myeloma have significantly fewer bacterial infections and IFD than patients with lymphoma, but a similar rate of CMV complications. Descriptive epidemiological data are consistent with the literature, indicating an overall incidence of 36%, 3.5% and 15.5% for bacterial infections, IFD and CMV complications, with a case mortality rate of 4%, 16.7% and 3.7%, respectively. A strong correlation between CMV and IFD exists, with 8 cases of IFD out of a total of 12 presenting a CMV complication. At multivariate analysis, a diagnosis of lymphoma, \u22653 previous treatment lines and age \u226560 years were found to be independent risk factors for IFD. Duration of neutropenia (ANC &lt; 500\/mm3) \u22657 days represents an independent risk factor for CMV complications, where neutropenia most likely represents a crude surrogate biomarker indicating a deeper and longer state of overall immunosuppression. From our data we conclude that (1) myeloma patients are at lower risk of bacterial infections and IFD as compared with lymphoma patients but are at equal risk of CMV complications, most likely as a consequence of a selective impact of bortezomib on Herpes Viruses infection control; (2) a significant association exists between CMV and IFD, although a possible cause-effect relationship remains to be determined; (3) IFD is a rare complication after ASCT but burdened by a mortality rate of about 17%, with peak rates in older lymphoma patients who underwent more intensive therapeutic regimens.<\/jats:p>","DOI":"10.3390\/ijms20061373","type":"journal-article","created":{"date-parts":[[2019,3,19]],"date-time":"2019-03-19T12:12:25Z","timestamp":1552997545000},"page":"1373","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Association between CMV and Invasive Fungal Infections After Autologous Stem Cell Transplant in Lymphoproliferative Malignancies: Opportunistic Partnership or Cause-Effect Relationship?"],"prefix":"10.3390","volume":"20","author":[{"given":"Francesco","family":"Marchesi","sequence":"first","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fulvia","family":"Pimpinelli","sequence":"additional","affiliation":[{"name":"Molecular Virology, Pathology and Microbiology, IRCCS San Gallicano Dermatological Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6295-6006","authenticated-orcid":false,"given":"Enea Gino","family":"Di Domenico","sequence":"additional","affiliation":[{"name":"Molecular Virology, Pathology and Microbiology, IRCCS San Gallicano Dermatological Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Renzi","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Gallo","sequence":"additional","affiliation":[{"name":"Molecular Virology, Pathology and Microbiology, IRCCS San Gallicano Dermatological Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Regazzo","sequence":"additional","affiliation":[{"name":"Genomic and Epigenetic Unit, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Giulia","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Genomic and Epigenetic Unit, Translational Research Area, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svitlana","family":"Gumenyuk","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Toma","sequence":"additional","affiliation":[{"name":"Infectious Disease Consultant, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirella","family":"Marino","sequence":"additional","affiliation":[{"name":"Pathology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iole","family":"Cordone","sequence":"additional","affiliation":[{"name":"Clinical Pathology Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Cantonetti","sequence":"additional","affiliation":[{"name":"Hematology Unit, Tor Vergata University Hospital, Viale Oxford, 81 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Marina","family":"Liberati","sequence":"additional","affiliation":[{"name":"Oncology-Hematology, Santa Maria Hospital, University of Perugia, Viale Tristano di Joannuccio, 05100 Terni, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Montanaro","sequence":"additional","affiliation":[{"name":"Hematology, Belcolle Hospital, Str. Sammartinese, 01100 Viterbo, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Ceribelli","sequence":"additional","affiliation":[{"name":"Medical Oncology, San Camillo de Lellis Hospital, Viale Kennedy, 02100 Rieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grazia","family":"Prignano","sequence":"additional","affiliation":[{"name":"Molecular Virology, Pathology and Microbiology, IRCCS San Gallicano Dermatological Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Palombi","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atelda","family":"Romano","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Papa","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Pisani","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Spadea","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Arcese","sequence":"additional","affiliation":[{"name":"Hematology Unit, Tor Vergata University Hospital, Viale Oxford, 81 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Ensoli","sequence":"additional","affiliation":[{"name":"Molecular Virology, Pathology and Microbiology, IRCCS San Gallicano Dermatological Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Mengarelli","sequence":"additional","affiliation":[{"name":"Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Via Elio Chianesi, 53 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1002\/hon.2453","article-title":"Cytomegalovirus infection in hematologic malignancy settings other than the allogeneic transplant","volume":"36","author":"Marchesi","year":"2018","journal-title":"Hematol. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.blre.2016.09.002","article-title":"SEIFEM (Sorveglianza Epidemiologica Infezioni Fungine nelle Emopatie Maligne) Group. Risk stratification for invasive fungal infections in patients with hematological malignancies: SEIFEM recommendations","volume":"31","author":"Pagano","year":"2017","journal-title":"Blood Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/j.1399-3062.2005.000111.x","article-title":"Cytomegalovirus infection after autologous stem cell transplantation: Incidence and outcome in a group of patients undergoing a surveillance program","volume":"7","author":"Rossini","year":"2005","journal-title":"Transpl. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1046\/j.1365-2141.2001.02487.x","article-title":"Cytomegalovirus infection and non-neutropenic fever after autologous stem cell transplantation: High rates of reactivation in patients with multiple myeloma and lymphoma","volume":"112","author":"Fassas","year":"2001","journal-title":"Br. J. Haematol."},{"key":"ref_5","first-page":"1672","article-title":"Cytomegalovirus DNAemia and disease: Incidence, natural history and management in settings other than allogeneic stem cell transplantation","volume":"90","author":"Ng","year":"2005","journal-title":"Haematologica"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1128\/JCM.01670-06","article-title":"Epidemiologic analysis of reactivated Cytomegalovirus antigenemia in adult patients with cancer","volume":"45","author":"Han","year":"2007","journal-title":"J. Clin. Microbiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1007\/s00277-016-2700-4","article-title":"Cytomegalovirus infection in autologous stem cell transplant recipients in the era of Rituximab","volume":"95","author":"Jain","year":"2016","journal-title":"Ann. Hematol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00277-016-2831-7","article-title":"Cytomegalovirus reactivation in patients with hematological diseases and after autologous stem cell transplantation as consolidation: A single-center study","volume":"96","author":"Piukovics","year":"2017","journal-title":"Ann. Hematol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1111\/tid.12162","article-title":"High incidence of post-transplant cytomegalovirus reactivations in myeloma patients undergoing autologous stem cell transplantation after treatment with bortezomib-based regimens: A survey from the Rome Transplant Network","volume":"16","author":"Marchesi","year":"2014","journal-title":"Transpl. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1111\/tid.12309","article-title":"Evaluation of risk of symptomatic cytomegalovirus reactivation in myeloma patients treated with tandem autologous stem cell transplantation and novel agents: A single-institution study","volume":"16","author":"Marchesi","year":"2014","journal-title":"Transpl. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"129","DOI":"10.5500\/wjt.v5.i3.129","article-title":"Cytomegalovirus reactivation after autologous stem cell transplantation in myeloma and lymphoma patients: A single-center study","volume":"5","author":"Marchesi","year":"2015","journal-title":"World J. Transplant."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1002\/ajh.22214","article-title":"The potential role of pre-transplant HBcIgGseropositivity as predictor of clinically relevant Cytomegalovirus infection in patients with lymphoma undergoing autologous hematopoietic stem cell transplantation: A study from the Rome Transplant Network","volume":"87","author":"Marchesi","year":"2012","journal-title":"Am. J. Hematol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jinf.2015.11.005","article-title":"Prospectiv esurveillance vs clinically driven approach for CMV reactivation after autologous stem cell transplant","volume":"72","author":"Mengarelli","year":"2016","journal-title":"J. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1086\/522189","article-title":"Fungal infections in recipients of hematopoietic stem cell transplants: Results of the SEIFEM B-2004 study\u2014SorveglianzaEpidemiologicaInfezioniFungine Nelle EmopatieMaligne","volume":"45","author":"Pagano","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1086\/651263","article-title":"Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001\u20132006: Overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database","volume":"50","author":"Kontoyiannis","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1038\/bmt.2008.303","article-title":"Increased risk for invasive aspergillosis in patients with lymphoproliferative diseases after autologous hematopoietic SCT","volume":"43","author":"Gil","year":"2009","journal-title":"Bone Marrow Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/j.bbmt.2015.03.018","article-title":"Epidemiology, management, and outcome of invasive fungal disease in patients undergoing hematopoietic stem cell transplantation in China: A multicenter prospective observational study","volume":"21","author":"Sun","year":"2015","journal-title":"Biol Blood Marrow Transplant."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1111\/1469-0691.12002","article-title":"Invasive fungal diseases in haematopoietic cell transplant recipients and in patients with acute myeloid leukaemia or myelodysplasia in Brazil","volume":"19","author":"Nucci","year":"2013","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.3324\/haematol.2014.114025","article-title":"Invasive fungal infections in patients with multiple myeloma: A multi-center study in the era of novel myeloma therapies","volume":"100","author":"Teh","year":"2015","journal-title":"Haematologica"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1038\/bmt.2009.78","article-title":"Lower respiratory tract respiratory virus infections increase the risk of invasive aspergillosis after a reduced-intensity allogeneic hematopoietic SCT","volume":"44","author":"Martino","year":"2009","journal-title":"Bone Marrow Transplant."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1182\/blood-2003-02-0456","article-title":"Risks and outcomes of invasive fungal infections in recipients of allogeneic hematopoietic stem cell transplants after non myeloablative conditioning","volume":"102","author":"Fukuda","year":"2003","journal-title":"Blood"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/j.bbmt.2017.07.025","article-title":"Cytomegalovirus Reactivation Is Associated with Increased Risk of Late-Onset Invasive Fungal Disease after Allogeneic Hematopoietic Stem Cell Transplantation: A Multicenter Study in the Current Era of Viral Load Monitoring","volume":"23","author":"Yong","year":"2017","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1093\/cid\/cix690","article-title":"Incidence, Risk Factors and Outcome of Pre-engraftment Gram-Negative Bacteremia After Allogeneic and Autologous Hematopoietic Stem Cell Transplantation: An Italian Prospective Multicenter Survey","volume":"65","author":"Girmenia","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1093\/cid\/cix646","article-title":"Antimicrobial Resistance in Gram-Negative Rods Causing Bacteremia in Hematopoietic Stem Cell Transplant Recipients: Intercontinental Prospective Study of the Infectious Diseases Working Party of the European Bone Marrow Transplantation Group","volume":"65","author":"Averbuch","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1016\/j.bbmt.2017.05.016","article-title":"Clinical Impact of Colonization with Multidrug-Resistant Organisms on Outcome after Autologous Stem Cell Transplantation: A Retrospective Single-Center Study","volume":"23","author":"Scheich","year":"2017","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1111\/j.1600-0609.2004.00273.x","article-title":"Invasive fungal infections in autologous stem cell transplant recipients: A nation-wide study of 1188 transplanted patients","volume":"73","author":"Jantunen","year":"2004","journal-title":"Eur. J. Haematol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/j.bbmt.2014.03.004","article-title":"Incidence and outcome of invasive fungal diseases after allogeneic stem cell transplantation: A prospective study of the Gruppo Italiano Trapianto Midollo Osseo (GITMO)","volume":"20","author":"Girmenia","year":"2014","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1002\/jmv.23735","article-title":"An investigation on the relationship between the occurrence of CMV DNAemia and the development of invasive aspergillosis in the allogeneic stem cell transplantation setting","volume":"86","author":"Solano","year":"2014","journal-title":"J. Med. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1046\/j.1365-2141.2002.03259.x","article-title":"Invasive fungal infections after allogeneic peripheral blood stem cell transplantation: Incidence and risk factors in 395 patients","volume":"116","author":"Martino","year":"2002","journal-title":"Br. J. Haematol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1097\/QCO.0000000000000502","article-title":"Invasive fungal disease and cytomegalovirus infection: Is there an association?","volume":"31","author":"Yong","year":"2018","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2928","DOI":"10.1182\/blood-2006-03-008706","article-title":"Impact of the intensity of the pretransplantation conditioning regimen in patients with prior invasive aspergillosis undergoing allogeneic hematopoietic stem cell transplantation: A retrospective survey of the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation","volume":"108","author":"Martino","year":"2006","journal-title":"Blood"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1086\/591969","article-title":"Epidemiology of invasive mold infections in allogeneic stem cell transplant recipients: Biological risk factors for infection according to time after transplantation","volume":"47","author":"Upton","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1038\/bmt.2009.39","article-title":"Risk factors for invasive aspergillosis and related mortality in recipients of allogeneic SCT from alternative donors: An analysis of 306 patients","volume":"44","author":"Mikulska","year":"2009","journal-title":"Bone Marrow Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1016\/j.bbmt.2009.08.006","article-title":"Incidence of Viral and fungal infections following busulfan-based reduced-intensity versus myeloablative conditioning in pediatric allogeneic stem cell transplantation recipients","volume":"15","author":"Satwani","year":"2009","journal-title":"Biol. Blood Marrow Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/j.1399-3062.2010.00497.x","article-title":"Risk factors and prognosis of invasive fungal infections in allogeneic stem cell transplantation recipients: A single-institution experience","volume":"12","author":"Zhang","year":"2010","journal-title":"Transpl. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"100","DOI":"10.3109\/00365548.2011.623311","article-title":"Risk factors for invasive mold infections following allogeneic hematopoietic stem cell transplantation: A single center study of 190 recipients","volume":"44","author":"Li","year":"2012","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/tid.12328","article-title":"Risk factors for invasive mold diseases in allogeneic hematopoietic cell transplant recipients","volume":"17","author":"Atalla","year":"2015","journal-title":"Transpl. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/1469-0691.12222","article-title":"Risk factors of Ganciclovir-related neutropenia after allogeneic stem cell transplantation: A retrospective monocentre study on 547 patients","volume":"20","author":"Venton","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"477","DOI":"10.4049\/jimmunol.182.1.477","article-title":"Human cytomegalovirus paralyzes macrophage motility through down-regulation of chemokine receptors, reorganization of the cytoskeleton, and release of macrophage migration inhibitory factor","volume":"182","author":"Frascaroli","year":"2009","journal-title":"J. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1128\/CMR.00055-08","article-title":"Pathogenesis of Aspergillus fumigatus in Invasive Aspergillosis","volume":"22","author":"Dagenais","year":"2009","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"10990","DOI":"10.1073\/pnas.93.20.10990","article-title":"Human cytomegalovirus inhibits antigen presentation by a sequential multistep process","volume":"93","author":"Ahn","year":"1996","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Stanzani, M., Lewis, R.E., Fiacchini, M., Ricci, P., Tumietto, F., Viale, P., Ambretti, S., Baccarani, M., Cavo, M., and Vianelli, N. (2013). A risk prediction score for invasive mold disease in patients with hematological malignancies. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0075531"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1038\/bmt.2008.162","article-title":"Management of CMV, HHV-6, HHV-7 and Kaposi-sarcoma herpesvirus (HHV-8) infections in patients with haematological malignancies and after SCT","volume":"42","author":"Ljungman","year":"2008","journal-title":"Bone Marrow Transplant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1097\/QCO.0b013e32821f6010","article-title":"Laboratory diagnosis of cytomegalovirus infection and disease in immunocompromised patients","volume":"20","author":"Drew","year":"2007","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1038\/sj.bmt.1701139","article-title":"Longitudinal fluctuations in cytomegalovirus load in bone marrow transplant patients: Relationship between peak virus load, donor\/recipient serostatus, acute GVHD and CMV disease","volume":"21","author":"Gor","year":"1998","journal-title":"Bone Marrow Transplant."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1086\/339329","article-title":"Definitions of Cytomegalovirus infection and disease in transplant recipients","volume":"34","author":"Ljungman","year":"2002","journal-title":"Clin. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/cid\/ciw668","article-title":"Definitions of Cytomegalovirus infection and disease in transplant patients for use in clinical trials","volume":"64","author":"Ljungman","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1086\/588660","article-title":"Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer\/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC\/MSG) consensus group","volume":"46","author":"Walsh","year":"2008","journal-title":"Clin. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1093\/clinids\/14.4.875","article-title":"Vascular catheter-associated fungemia in patients with cancer: Analysis of 155 episodes","volume":"14","author":"Lecciones","year":"1992","journal-title":"Clin. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1200\/JCO.2009.21.8032","article-title":"Clinically driven diagnostic approach in neutropenic patients: A prospective feasibility study","volume":"28","author":"Girmenia","year":"2010","journal-title":"J. Clin. Oncol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/20\/6\/1373\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:38:53Z","timestamp":1760186333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/20\/6\/1373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,19]]},"references-count":50,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,3]]}},"alternative-id":["ijms20061373"],"URL":"https:\/\/doi.org\/10.3390\/ijms20061373","relation":{},"ISSN":["1422-0067"],"issn-type":[{"type":"electronic","value":"1422-0067"}],"subject":[],"published":{"date-parts":[[2019,3,19]]}}}