Abstract
Cytomegalovirus (CMV) pneumonia is one of the serious complications known to occur after allogeneic bone marrow transplantation (BMT). The diagnosis is usually made by viral culture technique using the specimens obtained from blood, urine, throat swab, and bronchoalveolar lavage fluid or from lung biopsy specimens in marrow recipients with interstitial pneumonia. However, the specificity and sensitivity of viral culture is occasionally insufficient to make a correct diagnosis, and biopsy is invasive. In addition, it takes several days to obtain results. HRP-C7, originally reported by Eizuru et al. in 1991, is a human monoclonal antibody to immediate early antigen of CMV, and the immunoperoxidase method with HRP-C7 is reported to be reliable for the detection of CMV antigenemia. Furthermore, it takes only 24 hours to obtain the results. We experienced four cases of CMV infection after allogeneic BMT. Two of these four cases were diagnosed in their early phase of infection utilizing the HRP-C7 method, and treated with combination of ganciclovir and high-dose immunoglobulin before detection of abnormalities on chest X-ray film. Antigenemia resolved within 10 days after the initiation of the treatment. As a result, the patients did not develop typical symptoms and signs of CMV pneumonia. Three of four cases including these two are alive without disease recurrence.
