Late Cytomegalovirus Disease in Marrow Transplantation Is Predicted by Virus Load in Plasma

• Published in: The Journal of infectious diseases Vol. 176; no. 3; pp. 782 - 785
• Main Authors: Zaia, John A., Gallez-Hawkins, Ghislaine M., Tegtmeier, Bernard R., ter Veer, Anna, Li, Xiuli, Niland, Joyce C., Forman, Stephen J.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.09.1997; University of Chicago Press; Oxford University Press
• Subjects: AIDS/HIV; Biological and medical sciences; Blood; Blood plasma; Bone marrow; Bone Marrow Transplantation - adverse effects; Central nervous system viral diseases; Concise Communications; Cytomegalovirus; Cytomegalovirus - isolation & purification; Cytomegalovirus Infections - blood; Cytomegalovirus Infections - etiology; Cytomegalovirus Infections - virology; Disease risk; Follow-Up Studies; Genomes; Human viral diseases; Humans; Infections; Infectious diseases; Medical sciences; Miscellaneous; Nervous system diseases; Polymerase Chain Reaction; Predictive Value of Tests; Prospective Studies; Viral diseases; Viral Load; Human; Herpesviridae; Prediction; Recipient; Betaherpesvirinae; Human cytomegalovirus; Blood plasma; Infection; Virus; Viral disease; Risk factor; Bone marrow; Graft
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/517301

Late occurrence of cytomegalovirus (CMV) disease after day 100 after bone marrow transplantation has become an increasing problem; whether a quantitative measurement of CMV DNA in plasma by polymerase chain reaction (P-PCR) could be predictive of such disease was investigated. In a prospective study, 117 subjects undergoing allogeneic marrow transplantation were followed for 120 days with weekly CMV blood cultures, with day 35 bronchoalveolar lavage CMV cultures, with weekly CMV P-PCR, and with clinical follow-up for an additional 1–2 years. Despite preemptive ganciclovir, CMV disease occurred in 9% of subjects, with a median time of onset of 176 days. Quantitative CMV P-PCR was associated with the late development of CMV disease (P =.01). Of 43 subjects with positive P-PCR results, 23% developed CMV disease, but no disease occurred in the 74 subjects with negative P-PCR (P < .001), despite the fact that 22% had CMV isolated from lung lavage fluid and 32% had CMV isolated from blood.