Cytomegalovirus infection and non-neutropenic fever after autologous stem cell transplantation: high rates of reactivation in patients with multiple myeloma and lymphoma.
In a retrospective study, we examined the association between cytomegalovirus (CMV) infection and non-neutropenic fever immediately following autologous peripheral blood stem cell transplantation for a variety of haematological malignancies and solid tumours. Sixty non-neutropenic febrile episodes (41 in CMV-seropositive and 19 in CMV-seronegative patients) were evaluated. CMV reactivation, documented by CMV antigenaemia, was detected in 16 out of 41 (39%) seropositive patients compared with 0 out of 19 seronegative patients. In 12 of these 16 patients, CMV infection was considered the sole cause of fever. Thirteen patients had maximum antigenaemia levels > 5 cells/slide. Specific antiviral treatment led to the resolution of the fever in all, but two, patients, who developed fatal CMV pneumonia. Patients with multiple myeloma and lymphoma, possibly owing to a combination of disease-related characteristics and prior immunosuppressive treatment, had high rates of CMV reactivation and may require more frequent diagnostic evaluation and prompt therapeutic intervention.
Fassas
A B
AB
Greenebaum Cancer Center, University of Maryland, Baltimore, MD, USA. FassasAthanasios@exchange.uams.edu
Bolaños-Meade
J
J
Buddharaju
L N
LN
Rapoport
A
A
Cottler-Fox
M
M
Chen
T
T
Lovchik
J C
JC
Cross
A
A
Tricot
G
G
D000328:Adult; D000368:Aged; D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000821:virology*; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008223:Lymphoma / Q000601:surgery* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000601:surgery* / Q000821:virology; D011183:Postoperative Complications / Q000188:drug therapy / Q000821:virology*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D014775:Virus Activation
D000956:Antigens, Viral; D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir