Cytomegalovirus seroconversion in patients receiving intensive induction therapy prior to allogeneic bone marrow transplantation

Bone Marrow Transplant. 1989 Sep;4(5):543-6.

Abstract

Cytomegalovirus (CMV) seropositivity in recipients of an allogeneic bone marrow transplant (BMT) is a major risk factor for development of post-transplant CMV infection. CMV serology was assessed in 98 patients during intensive chemotherapy for haematological malignancy prior to allogeneic BMT. Thirty-seven patients eventually received a BMT; the remaining 61 patients were treated with chemotherapy alone. The proportion of seropositive patients in the BMT group increased from 36% to 48% between presentation and transplantation. This represents an increase in recipient seropositivity of 33% as a direct result of pre-transplant therapy. Mean time to seroconversion was 186 days. Seropositivity in patients receiving chemotherapy only increased from 43% to 56% during treatment and follow-up. The most likely source of the CMV acquired by these patients is CMV-infected blood products. We suggest that, wherever possible, CMV-negative blood products should be used exclusively from presentation to support all patients receiving chemotherapy in whom BMT is a therapeutic option.

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / analysis*
  • Antineoplastic Agents / therapeutic use
  • Bone Marrow Transplantation / adverse effects*
  • Bone Marrow Transplantation / immunology
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Cytomegalovirus / immunology*
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / prevention & control
  • Female
  • Humans
  • Leukemia / drug therapy
  • Leukemia / surgery
  • Male
  • Middle Aged
  • Pneumonia, Viral / etiology
  • Pneumonia, Viral / prevention & control
  • Retrospective Studies
  • Transfusion Reaction
  • Transplantation, Homologous

Substances

  • Antibodies, Viral
  • Antineoplastic Agents