Cytomegalovirus DNAemia and treatment following allogeneic stem cell transplantation with a focus on long-term outcome.

Cytomegalovirus (CMV) is an important factor for morbidity and long-term outcome after allogeneic haematopoetic stem cell transplantation (allo-SCT). Cases of proven and probable CMV infection and disease among 97 allo-SCT recipients in Gothenburg, Sweden, 1997-2001, were analysed. CMV DNAemia was detected in 60 patients at a median of 30 days after SCT. Four patients (4%) had CMV disease; 2 had proven and 2 had probable CMV disease. Of these 4 patients, 1 died of CMV disease. In 1 additional patient, CMV was considered to have contributed to the patient's death. Fifty patients (51%) were treated in a total of 93 treatment episodes. The overall 1-y survival was 75% and the 5-y survival 55%. Patients with diagnosed CMV DNAemia had improved survival. No significant differences in survival rates were seen between the donor/recipient serological groups. An increased risk of CMV DNAemia was seen after SCT with a seronegative donor to a seropositive recipient. CMV disease with debut more than 110 days after transplantation was related to steroid treatment for graft-versus-host disease. The morbidity related to CMV disease following allo-SCT was low over the past 10 y, probably due to CMV surveillance and early treatment.