[Cytomegalovirus diseases after allogeneic hematopoietic stem cell transplantation (Allo-HSCT) and related risk factors].
OBJECTIVE
To analyze the incidence of cytomegalovirus (CMV) diseases after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and related risk factors.


METHODS
The clinical data of 131 patients undergoing allo-HSCT August 1999 to July 2001 were analyzed retrospectively.


RESULTS
Twenty-eight of the 131 patients developed CMV interstitial pneumonia (IP) with an incidence rate of 21.35%, 9 patients developed CMV enteritis with an incidence rate of 6.87%; in total 37 of the 131 patients developed CMV disease with the accumulative one-year incidence rate of 32.54%. Thirteen patients (35.14%)died of CMV diseases. Univariate analysis showed that accumulative incidence of CMV disease was associated with unrelated donor, II-IV degrees acute graft versus host disease (aGVHD), additional immunosuppressive therapy for GVHD, chronic graft versus host disease (cGVHD), antilymphocyte globulin (ALG)/monoclonal antibody (MoAb) administration, high dose of methylprednisolone (MP), plasma viramia-PCR (PV-PCR) positivity of patients, blood transfusion and pre-emptive treatment. Multivariate analysis showed that risk factors for CMV disease included plasma CMV-DNA positivity, immense amount of blood transfused, and additional immunosuppressive therapy for aGVHD, and pre-emptive therapy capable of turning PV-PCR positive reduced the incidence of CMV disease (RR: 3.309, 1.046, 2.242, and 0.346).


CONCLUSIONS
CMV disease has a high morbidity and mortality in allo-HSCT patients. Patients with positive plasma CMV-DNA should receive pre-emptive therapy till their plasma CMV-DNA turns to be negative, especially in condition of severe aGVHD, immense amount of blood transfused, or additional immunosuppressive therapy.
Huang
Xiao-jun
XJ
Institute of Hematology, People's Hospital, Peking University, Beijing 100044, China.
Xu
Lan-ping
LP
Ren
Han-yun
HY
Zhang
Yao-chen
YC
Guo
Nai-lan
NL
Lu
Dao-pei
DP
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004279:DNA, Viral / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000601:surgery; D017563:Lung Diseases, Interstitial / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014184:Transplantation, Homologous
D004279:DNA, Viral