A single‐center experience of cytomegalovirus infections in A sian pediatric patients undergoing allogeneic hematopoietic stem cell transplant for leukemia in S ingapore

• Published in: Transplant infectious disease Vol. 16; no. 4; pp. 556 - 560
• Main Authors: Tan, P.L., Lim, L.M., Khanlian, C., Villegas, M.S.
• Format: Journal Article
• Language: English
• Published: 01.08.2014
• ISSN: 1398-2273; 1399-3062
• DOI: 10.1111/tid.12238

Abstract Introduction Cytomegalovirus ( CMV ) infection remains a significant cause of morbidity and mortality in pediatric patients undergoing allogeneic hematopoietic stem cell transplantation ( HSCT ) despite improved surveillance and the current preemptive approach. Few data on its prevalence in the Asian pediatric population exist. Methods We retrospectively reviewed the prevalence of CMV infections in 33 patients with 37 transplants who received HSCT for leukemia from 1998 to 2008, and who were managed preemptively for infections. Results In the 37 transplants, 16 patients (43%) had CMV DNA emia. Of the patients who were CMV seropositive before transplant and received stem cells from seropositive donors (R+/D+), 69% had DNA emia; of those who received stem cells from seronegative donors (R+/D−), 36% had CMV DNA emia. Of the patients who were CMV naïve before transplant and received stem cells from seropositive donors (R−/D+), 25% had CMV DNA emia. In CMV ‐seronegative donor–recipient transplants (R−/D−), 20% of patients had CMV DNAemia. The median time to the first episode of CMV DNA emia was 21 (range: 10–107) days after the transplants, and the median duration of CMV DNA emia was 22 (range: 2–315) days. CMV DNA emia recurred in 44% (7 of 16) of these patients. Only 1 patient developed CMV disease (retinitis). No deaths were related to CMV infections. Conclusions CMV infection manifesting as DNA emia is a common complication in pediatric patients undergoing allogeneic HSCT for leukemia. Pre‐transplant serostatus predicts reactivation risks; invasive CMV disease is rare using the preemptive approach in our patient population.