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.
Fred Hutchinson Cancer Research Center, Program in Infectious Diseases, Seattle, WA 98104, USA.
M
M
Boeckh
T
T
Stevens-Ayers
R A
RA
Bowden
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