[Risk factors of cytomegalovirus infection and antiviral efficacy in recipients of hematopoietic stem cell transplantation].
OBJECTIVE
To analyze the incidence, risk factors and antiviral effect of cytomegalovirus infection after hematopoietic stem cell transplantation (HSCT).


METHODS
Two hundred and two patients who underwent HSCT in our institution from Jan, 1998 to Dec, 2000 were analyzed in a retrospective way. Conditioning regimens consisted of total body irradiation (TBI) or busulfan plus cyclophosphomide. Allo-HSCT patients received cyclosporn A and short-term methotrexate as graft-versus host disease (GVHD) prophylaxis. As prophylaxis of CMV infection, 10 mg x (kg(-1) x d(-1)) ganciclovir were used per day for eight days before HSCT. Cytomegalovirus was detected after HSCT once a week using polymerase chain reaction (PCR) method. If CMV was positive or patients had signs of CMV disease, ganciclovir or/and foscarnet was used for the treatment.


RESULTS
The incidence of CMV infection was 35.6% (72/202). Among these active infections, interstitial pneumonia accounted for 44.4%, viraemia 33.3% and CMV enteritis 13.9%. The peak interval of infection was from 60 to 90 days after HSCT. Effective rate of anti-CMV treatment was about 60%. Allo-HSCT, acute and chronic GVHD were important risk factors for CMV infection. Age, sex, disease status before HSCT, pre-conditioning regimen were not significantly associated with the occurrence of CMV infection.


CONCLUSIONS
CMV infection is one of the important complications of allo-HSCT.Effective prevention and treatment may improve the survival rate for these patients.
Ding
Haowei
H
Institute of Hematology   Peking University People  s Hospital, Beijing 100044, China.
Ren
Hanyun
H
Guo
Nailan
N
Huang
Xiaojun
X
Xu
Lanping
L
Zhang
Yaochen
Y
Lu
Daopei
D
D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D015774:Ganciclovir