CYTOMEGALOVIRUS REACTIVATION IN ADULT RECIPIENTS OF AUTOLOGOUS STEM CELL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE

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omar ziad alrawi
fawzi abdel-latif abdel-rahman
rula alnajjar
husam abujazar
mourad salam
mustafa saad

Keywords

utologoCytomegalovirus, CMV, reactivation, aus, stem cell transplantation

Abstract

Introduction: Cytomegalovirus (CMV) reactivation and infection is a well-recognized complication after allogeneic stem cell transplantation (SCT). Yet only few studies have addressed CMV reactivation after autologous SCT (ASCT).

Methods: We retrospectively reviewed medical records of 210 adult patients who underwent ASCT for lymphoma or multiple myeloma (MM) at a single center from January 1, 2007 until December 31, 2012. All patients were monitored weekly with CMV antigenemia test till day 42 after transplantation, and for 2 months after last positive test in those who had any positive CMV antigenemia test before day 42.

Results: thirty seven (17.6%) patients had CMV reactivation; 23 patients had lymphoma while 14 had MM as the underlying disease. There was no difference in the rate of CMV reactivation between lymphoma and MM patients (20% versus 14.7%, P = 0.32). The majority of the patients were treated with ganciclovir/valganciclovir, all patients had their reactivation resolved with therapy, and none developed symptomatic CMV infection. None of the patients who died within 100 days of transplantation had CMV reactivation. Log rank test showed that CMV reactivation had no effect on the overall survival or the disease-free survival of patients (P values, 0.29 and 0.79, respectively).

Conclusion: In our cohort, CMV reactivation rate after ASCT was 17.6%. There was no difference in reactivation rates between lymphoma and MM patients. With the use of preemptive therapy, symptomatic CMV infection was not documented in any patient in our cohort. CMV reactivation had no impact on patients’ survival post ASCT. 

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