Lymphoid malignancy is a risk factor for CMV infection in the early phase of allogeneic stem cell transplantation.

Abstract

 To examine risk factors for cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HCT), CMV infection was monitored weekly using both real-time quantitative polymerase chain reaction (RQ-PCR) and an antigenemia (Ag) assay in 81 patients who underwent allo-HCT. The relationship between clinical features and CMV status was analyzed retrospectively. Although the Ag assay could not be used until 2-3 weeks after allo-HCT because of a low white blood cell count, CMV DNA could be detected using RQ-PCR even in the early phase after allo-HCT. There was a significant correlation between viral load determined by the Ag assay and RQ-PCR. The detection rate with RQ-PCR was significantly higher than with the Ag assay 4 weeks after allo-HCT. Significantly more patients received pre-emptive therapy up until Day 100 after allo-HCT in the CMV-positive compared with CMV-negative groups, identified using RQ-PCR 3 and 4 weeks after allo-HCT. Compared with myeloid malignancy, patients with lymphoid malignancy had a significantly higher viral load 3 and 4 weeks after allo-HCT (RQ-PCR P=0.02 and P=0.014; Ag assay P=0.005 and P=0.002), and significantly more were undergoing pre-emptive therapy. Patients with low serum IgG levels before allo-HCT also had a significantly higher viral load than those with normal serum IgG concentrations 2 weeks after allo-HCT. Thus, it is recommended that these patients are monitored carefully for CMV after allo-HCT.