CMV-viraemia during allogenic bone marrow transplantation in paediatric patients: association with survival and graft-versus-host disease.
Sixty-one consecutive paediatric patients undergoing allogenic bone marrow transplantation (BMT) were screened prospectively for cytomegalovirus (CMV)-viraemia by PCR. Sixteen patients (26%) presented with single or recurrent CMV-viraemia between day -7 and + 100. Although only four of them had evidence of CMV-disease, there was a significant difference in the incidence of acute Graft versus Host Disease (GVHD) grade III-IV (75% vs 15.5%), liver-involvement (68% vs 13%) and the incidence of chronic GVHD (83% vs 13.8%) between CMV-PCR-positive and CMV-PCR-negative patients. Transplant-related mortality (TRM) was 43.7% in the CMV-PCR-positive group versus 13% in patients which had no evidence for CMV-viraemia. In all but one cases mortality in CMV-PCR positive patients was GVHD-associated. Pre-emptive therapy with gancyclovir in case of CMV-viraemia seemed to have no impact on incidence and severity of GVHD.
Matthes-Martin
S
S
St Anna Children's Hospital, Vienna, Austria. matthes-martin@CCRI.univie.ac.at
Aberle
S W
SW
Peters
C
C
Holter
W
W
Popow-Kraupp
T
T
Pötschger
U
U
Fritsch
G
G
Ladenstein
R
R
Rosenmayer
A
A
Dieckmann
K
K
Gadner
H
H
D000293:Adolescent; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000209:etiology*; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology*; D006801:Humans; D007223:Infant; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D014184:Transplantation, Homologous; D014766:Viremia / Q000209:etiology*