Cytomegalovirus pp65 antigenemia after autologous marrow and peripheral blood stem cell transplantation.
In a prospective study, the cytomegalovirus (CMV) pp65 antigenemia assay was compared with detection of CMV by blood culture in 67 consecutive CMV-seropositive patients undergoing autologous marrow or peripheral blood stem cell transplantation. Antigenemia occurred in 26 patients (38.8%) a median of 33 days (range, 12-74) after transplant. Viremia was detected in 5 patients (7.5%) a median of 30 days (range, 12-74) after transplant and was treated with ganciclovir in 3. Antigenemia occurred sporadically at low levels (< 5 positive cells/slide) in 19 patients (28.4%) and never resulted in CMV disease. Two of 7 patients who presented with or progressed to antigenemia of > 5 positive cells/slide developed fatal CMV pneumonia 8 days later. Neither patient had CMV viremia before onset of pneumonia. Thus, quantitative CMV pp65 antigenemia may be useful in guiding antiviral treatment in seropositive autograft recipients.
Boeckh
M
M
Fred Hutchinson Cancer Research Center, Program in Infectious Diseases, Seattle, WA 98104, USA.
Stevens-Ayers
T
T
Bowden
R A
RA
D000328:Adult; D000368:Aged; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003586:Cytomegalovirus Infections / Q000453:epidemiology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000097:blood*; D011446:Prospective Studies; D014182:Transplantation, Autologous; D014763:Viral Matrix Proteins / Q000097:blood*; D014766:Viremia / Q000453:epidemiology*
D010750:Phosphoproteins; D014763:Viral Matrix Proteins; C065418:cytomegalovirus matrix protein 65kDa