The objective of the work was to evaluate the frequency and time of incidence of cytomegaloviral (CMV)
infection and disease in patients after allogeneic
bone marrow transplantation (BMT). One hundred patients were followed up (70 with a related and 30 with an unrelated donor), who had
transplantations during the period between XI/1996-XI/2000.
METHODS USED: nested-PCR (MIE-gene) and antigenaemia (
antigen pp65). Active CMV
infection was proved in antigenaemia > or = 5 positive cells or in two consecutive positive PCR. The CMV syndrome was assessed in confirmed CMV
infection and otherwise inexplicable febrile conditions and/or a drop of haemogram values. For the diagnosis of CMV
pneumonia the clinical picture was needed, evidence of active CMV
infection and on the X-ray of the lungs
interstitial pneumonia. In 33 patients both methods were used, in 67 only PCR. The first positive test appeared 6-321 days after BMT (median +/- 49 days). CMV
infection was proved in 44% cases, CMV syndrome in 30% and CMV
pneumonia in 4%. In patients with a related donor CMV
infection was found in 34.3%, CMV syndrome in 22.9%, CMV
pneumonia in 1.4%. After unrelated donor BMT CMV
infection was recorded in 66.7%, CMV syndrome in 46.7% and CMV
pneumonia in 10% patients. Two patients died from CMV
pneumonia. CMV
pneumonia was diagnosed 57-115 days after BMT (median +/- 68 days. The risk of CMV
infection is high in both groups of patients, in particular in patients after unrelated donor BMT (66.7%). As far as the development of CMV
pneumonia was concerned, the mortality in the authors' group was 50%.