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Cytomegalovirus infection after autologous bone marrow transplantation:
occurrence of cytomegalovirus disease and effect on engraftment
P Reusser, LD Fisher, CD Buckner, ED Thomas and JD Meyers
Fred Hutchinson Cancer Research Center, Seattle, WA 98104.
Epidemiologic and clinical characteristics of cytomegalovirus (CMV)
infection and disease were analyzed retrospectively in 159 autologous
marrow transplant recipients. The probability of CMV infection by day 100
after transplant was 22.5% in patients seronegative to CMV before
transplant versus 61.1% in seropositive patients (P less than .0001 by
logrank test). Multivariate analysis identified positive pretransplant CMV
serology as the only definable risk factor for CMV infection (relative risk
1.4, P less than .0001). CMV pneumonia developed in 11 patients at a median
time of 100 days after transplant and was fatal in nine cases. CMV
pneumonia was associated with significantly decreased probability of
survival by day 100 after transplant (relative risk of death of 16.7, P
less than .0001). In contrast to earlier reports, CMV infection had no
significant effect on the rapidity of platelet or neutrophil recovery after
transplant as assessed by time-dependent multivariate analysis. Because the
incidence of severe CMV disease is not negligible after autologous marrow
transplantation, preventive measures against CMV infection are warranted,
as in allogeneic marrow transplantation.
Volume 75,
Issue 9,
pp. 1888-1894,
05/01/1990
Copyright © 1990 by The American Society of Hematology
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