TY - JOUR
T1 - Cytomegaloviremia after autografting for leukemia
T2 - Clinical significance and lack of effect on engraftment
AU - Singhal, S.
AU - Powles, R.
AU - Treleaven, J.
AU - Horton, C.
AU - Pinkerton, C. R.
AU - Meller, S.
AU - Mehta, J.
PY - 1997
Y1 - 1997
N2 - One hundred and fourteen patients with leukemia (66 cytomegalovirus (CMV)-seropositive and 48 CMV-seronegative) were monitored for cytomegaloviremia by early antigen detection or conventional viral culture after autologous stem cell transplantation (ASCT). Twenty-two episodes of viremia were seen at 2-36 weeks (median 11) in 14 seropositive patients. Nineteen resolved without therapy in 11 patients. Three patients with clinical features suggestive of CMV disease were treated with ganciclovir: viremia resolved prior to ganciclovir in one, and with 3 weeks of ganciclovir in the other two. Transient thrombocytopenia (n = 4) and leukopenia (n = 1) were seen in association with five episodes of viremia. The counts recovered in all five patients; with ganciclovir (n = 2) or with spontaneous clearance of viremia (n = 3). One seronegative patient developed viremia which resolved spontaneously in 3 weeks. No symptoms suggestive of CMV disease were seen in any of the other patients. CMV serostatus or development of CMV infection did not affect hematologic recovery. In our experience, cytomegaloviremia is relatively uncommon after autografting for leukemia, and usually does not require treatment. We now do not routinely monitor leukemia patients for CMV infection after autografting, but look for viremia in CMV-seropositive patients with unexplained fever, drop in blood counts, lung infiltrates, or gastrointestinal symptoms.
AB - One hundred and fourteen patients with leukemia (66 cytomegalovirus (CMV)-seropositive and 48 CMV-seronegative) were monitored for cytomegaloviremia by early antigen detection or conventional viral culture after autologous stem cell transplantation (ASCT). Twenty-two episodes of viremia were seen at 2-36 weeks (median 11) in 14 seropositive patients. Nineteen resolved without therapy in 11 patients. Three patients with clinical features suggestive of CMV disease were treated with ganciclovir: viremia resolved prior to ganciclovir in one, and with 3 weeks of ganciclovir in the other two. Transient thrombocytopenia (n = 4) and leukopenia (n = 1) were seen in association with five episodes of viremia. The counts recovered in all five patients; with ganciclovir (n = 2) or with spontaneous clearance of viremia (n = 3). One seronegative patient developed viremia which resolved spontaneously in 3 weeks. No symptoms suggestive of CMV disease were seen in any of the other patients. CMV serostatus or development of CMV infection did not affect hematologic recovery. In our experience, cytomegaloviremia is relatively uncommon after autografting for leukemia, and usually does not require treatment. We now do not routinely monitor leukemia patients for CMV infection after autografting, but look for viremia in CMV-seropositive patients with unexplained fever, drop in blood counts, lung infiltrates, or gastrointestinal symptoms.
KW - Autologous bone marrow transplantation
KW - Cytomegaloviremia
KW - Cytomegalovirus infection
KW - Foscarnet
KW - Ganciclovir
KW - Interstitial pneumonitis
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U2 - 10.1038/sj.leu.2400672
DO - 10.1038/sj.leu.2400672
M3 - Article
C2 - 9177437
AN - SCOPUS:0030955838
VL - 11
SP - 835
EP - 838
JO - Leukemia
JF - Leukemia
SN - 0887-6924
IS - 6
ER -