Limited predictive value of real-time quantitative PCR cytomegalovirus monitoring in the blood. Fatal CMV pneumonia in an autologous stem cell transplant recipient previously treated with alemtuzumab.
BACKGROUND
Patients treated with alemtuzumab are at very high risk for cytomegalovirus (CMV) reactivation. Also, in those who develop reactivation short time before stem cell transplantation the risk of fatal complications is extremely high.


METHODS
We describe a 21-year-old patient with anaplastic large T-cell lymphoma who developed CMV reactivation after alemtuzumab treatment and received high-dose chemotherapy with autologous stein cell transplantation for progressive disease and severe bone marrow aplasia. Blood samples of the patient were tested regularly for CMV reactivation with real-time quantitative PCR. Even though it is considered the most sensitive available method it did not allow us to predict in advance development of fatal CMV pneumonia in this patient.


CONCLUSIONS
The case report illustrates limitations of prognostic value of quantitative real-time PCR CMV assessment in blood samples.
Halaburda
Kazimierz
K
Department of Stem Cell Transplantation, Institute of Haematology and Transfusion Medicine, Warsaw, Poland. transplantacja@ihit.waw.pl
Nasiłowska-Adamska
Barbara
B
Grabarczyk
Piotr
P
Szczepiński
Andrzej
A
Szpila
Tomasz
T
Warzocha
Krzysztof
K
Mariańska
Bozena
B
D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003586:Cytomegalovirus Infections / Q000139:chemically induced / Q000175:diagnosis*; D004279:DNA, Viral / Q000097:blood*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy / Q000601:surgery; D011024:Pneumonia, Viral / Q000139:chemically induced / Q000175:diagnosis*; D016133:Polymerase Chain Reaction; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D004279:DNA, Viral; D000074323:Alemtuzumab