Abstract
Serum cytomegalovirus (CMV) titers (CF, EIA-IgG, -IgM) were analyzed in 122 pediatric leukemia and lymphoma patients (92 ALL, 12 AML, 16 NHL/HD, and 2 CML/JCML). At the study, 46 cases (38%) were seronegative (CF <4), 59 cases (48%) were seropositive with low titer (4-5. CF <64), and 17 cases (14%) with a high titer (CF ≥ 64). There was no correlation between CMV titers and the types of underlying disease or of chemotherapy, though the number of patients with a CMV high titer seemed to be increased between 15 to 60 months after the initiation of chemotherapy. In 52 of the 122 cases, CMV titers were compared before treatment and at the study. Of the 28 cases who were seronegative before treatment, 12 (43%) were seroconverted and of the 24 seropositive cases, 13 cases acquired more than 4-fold increase in CMV CF titer during the period. In analysis of the 17 patients with a high CMV titer, CMV-IgM was found to be positive in 4 (24%) (it was 0/59 in the low CMV titer group, p<0.01) and seven episodes of overt CMV disease were recorded in six cases. CMV genome was also positive in peripheral blood by PCR in 4 of these high CMV titer cases. These results show that pediatric leukemia/lymphoma patients with a high CMV titer are at high risk of CMV activation. Caution must be exercised that these patients are required to be checked routinely for immune function test and ophthalmological examinations. In addition, seronegative blood products should be supplied to seronegative patients to prevent CMV infection.
