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.
Conclusion: CMV infection is one of the important complications of allo-HSCT.Effective prevention and treatment may improve the survival rate for these patients.