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Cytomegalovirus infection after bone marrow transplantation in children.

Abstract
Cytomegalovirus (CMV) is a well-known cause of disease occurring after bone marrow transplantation (BMT). The manifestations of CMV range from asymptomatic infection, defined as active CMV replication in the blood in the absence of clinical manifestations or organ failure abnormalities, to CMV disease, characterized by CMV infection with clinical symptoms or organ function abnormalities. Diagnostic procedures to assess the viral load have improved greatly with the increased use of antigenemia, CMV DNA, and immediate early-messenger RNA. Many conditions concur in determining the risk of developing CMV reactivation or disease after bone marrow transplant with serologic status of donor and recipient, type of bone marrow transplant, presence of graft-versus-host disease being the most studied. However, time and quality of immune reconstitution seems to be the pivotal factors. Pneumonia and gastrointestinal involvement are the most frequently documented clinical pictures with late-onset CMV reactivation or disease representing a new challenge. CMV prophylaxis or pre-emptive therapy adopted during the last few years in allogeneic BMT recipients has changed the natural history of the disease, reducing the risk of CMV disease, CMV-associated death, transplant-related mortality, and has prolonged the period at risk. Specific studies on children are lacking, however, the clinical pictures and features seems to be similar both in children and adults.
AuthorsElio Castagnola, Barbara Cappelli, Daniela Erba, Anna Rabagliati, Edoardo Lanino, Giorgio Dini
JournalHuman immunology (Hum Immunol) Vol. 65 Issue 5 Pg. 416-22 (May 2004) ISSN: 0198-8859 [Print] United States
PMID15172440 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References
  • DNA, Viral
  • Phosphoproteins
  • RNA, Viral
  • Viral Matrix Proteins
  • cytomegalovirus matrix protein 65kDa
Topics
  • Bone Marrow Transplantation (adverse effects, immunology)
  • Child
  • Cytomegalovirus Infections (diagnosis, etiology, prevention & control)
  • DNA, Viral (metabolism)
  • Gastrointestinal Diseases (complications, etiology, pathology)
  • Graft Rejection (etiology)
  • Graft vs Host Disease (complications)
  • Humans
  • Lung Diseases, Interstitial (complications, etiology, pathology)
  • Phosphoproteins (metabolism)
  • RNA, Viral (metabolism)
  • Recurrence
  • Risk Factors
  • Roseolovirus Infections (complications)
  • Time Factors
  • Transfusion Reaction
  • Transplantation, Autologous (adverse effects, immunology)
  • Transplantation, Homologous (adverse effects, immunology)
  • Viral Matrix Proteins (metabolism)

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