title: Late cytomegalovirus disease in marrow transplantation is predicted by virus load in plasma.
abstract: Late occurrence of cytomegalovirus (CMV) disease after day 100 after bone marrow transplantation has become an increasing problem; whether a quantitative measurement of CMV DNA in plasma by polymerase chain reaction (P-PCR) could be predictive of such disease was investigated. In a prospective study, 117 subjects undergoing allogeneic marrow transplantation were followed for 120 days with weekly CMV blood cultures, with day 35 bronchoalveolar lavage CMV cultures, with weekly CMV P-PCR, and with clinical follow-up for an additional 1-2 years. Despite preemptive ganciclovir, CMV disease occurred in 9% of subjects, with a median time of onset of 176 days. Quantitative CMV P-PCR was associated with the late development of CMV disease (P = .01). Of 43 subjects with positive P-PCR results, 23% developed CMV disease, but no disease occurred in the 74 subjects with negative P-PCR (P < .001), despite the fact that 22% had CMV isolated from lung lavage fluid and 32% had CMV isolated from blood.
authors.affiliation: Department of Pediatrics, City of Hope National Medical Center, Duarte, California 91010, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Zaia
authors.forename: G M
authors.initials: GM
authors.lastname: Gallez-Hawkins
authors.forename: B R
authors.initials: BR
authors.lastname: Tegtmeier
authors.forename: A
authors.initials: A
authors.lastname: ter Veer
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: J C
authors.initials: JC
authors.lastname: Niland
authors.forename: S J
authors.initials: SJ
authors.lastname: Forman
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000097:blood / Q000209:etiology / Q000821:virology*; D005500:Follow-Up Studies; D006801:Humans; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019562:Viral Load