Cytomegalovirus seroconversion in patients receiving intensive induction therapy prior to allogeneic bone marrow transplantation.
Cytomegalovirus (CMV) seropositivity in recipients of an allogeneic bone marrow transplant (BMT) is a major risk factor for development of post-transplant CMV infection. CMV serology was assessed in 98 patients during intensive chemotherapy for haematological malignancy prior to allogeneic BMT. Thirty-seven patients eventually received a BMT; the remaining 61 patients were treated with chemotherapy alone. The proportion of seropositive patients in the BMT group increased from 36% to 48% between presentation and transplantation. This represents an increase in recipient seropositivity of 33% as a direct result of pre-transplant therapy. Mean time to seroconversion was 186 days. Seropositivity in patients receiving chemotherapy only increased from 43% to 56% during treatment and follow-up. The most likely source of the CMV acquired by these patients is CMV-infected blood products. We suggest that, wherever possible, CMV-negative blood products should be used exclusively from presentation to support all patients receiving chemotherapy in whom BMT is a therapeutic option.
Kelsey
S M
SM
Department of Haematology, London Hospital, Whitechapel, UK.
Newland
A C
AC
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007938:Leukemia / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000209:etiology / Q000517:prevention & control; D012189:Retrospective Studies; D065227:Transfusion Reaction; D014184:Transplantation, Homologous
D000914:Antibodies, Viral; D000970:Antineoplastic Agents