title: Cytomegalovirus infections in bone marrow transplant recipients given intensive cytoreductive therapy.
abstract: Cytomegalovirus (CMV) infections were studied in 785 bone marrow transplant recipients given intensive cytoreductive therapy. CMV excretion occurred in 24%, viremia in 9%, seroconversion in 40%, and overall active infection in 47%. CMV disease was much less common. Retinitis, enteritis, and pneumonitis occurred in only one, five (less than 1%), and 55 (7%) of the patients, respectively. Allograft recipients were more likely to develop CMV disease than were autograft patients (P = .0001) despite comparable rates of active CMV infection. CMV disease was rare after primary infection in both autograft and allograft recipients (0 and 1%, respectively). In contrast, CMV disease occurred in 16% of seropositive allograft recipients. Among allograft recipients, risk factors for CMV pneumonitis were seropositivity, age greater than 10 years, and acute graft-vs.-host disease, while the use of cyclosporine as prophylaxis against graft-vs.-host disease was protective. Although active infection rates did not decrease, the rates of CMV pneumonitis in allograft recipients during successive years declined significantly (P less than .001).
authors.affiliation: Oncology Center, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205.
authors.forename: J R
authors.initials: JR
authors.lastname: Wingard
authors.forename: S
authors.initials: S
authors.lastname: Piantadosi
authors.forename: W H
authors.initials: WH
authors.lastname: Burns
authors.forename: M L
authors.initials: ML
authors.lastname: Zahurak
authors.forename: G W
authors.initials: GW
authors.lastname: Santos
authors.forename: R
authors.initials: R
authors.lastname: Saral
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000209:etiology*; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000628:therapy; D011024:Pneumonia, Viral / Q000209:etiology; D012307:Risk Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous