Al-Rawi Omar, Abdel-Rahman Fawzi, Al-Najjar Rula, Abu-Jazar Husam, Salam Mourad, Saad Mustafa
Stem cell & bone marrow transplantation program, King Hussein Cancer Center, Amman, Jordan.
Division of Infectious Diseases, Prince Sultan Cardiac Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Mediterr J Hematol Infect Dis. 2015 Aug 24;7(1):e2015049. doi: 10.4084/MJHID.2015.049. eCollection 2015.
Cytomegalovirus (CMV) reactivation and infection are well-recognized complications after allogeneic stem cell transplantation (SCT). Only a few studies have addressed CMV reactivation after autologous SCT (ASCT).
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(st), 2007 until December 31(st), 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.
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 of patients (P values, 0.29).
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.
巨细胞病毒（CMV）再激活和感染是异基因干细胞移植（SCT）后公认的并发症。仅有少数研究探讨了自体SCT（ASCT）后的CMV再激活情况。
我们回顾性分析了2007年1月1日至2012年12月31日在单一中心接受ASCT治疗淋巴瘤或多发性骨髓瘤（MM）的210例成年患者的病历。所有患者在移植后第42天前每周进行CMV抗原血症检测，对于在第42天前有任何CMV抗原血症检测呈阳性的患者，在最后一次阳性检测后持续监测2个月。
37例（17.6%）患者出现CMV再激活；23例患者潜在疾病为淋巴瘤，14例为MM。淋巴瘤和MM患者的CMV再激活率无差异（20%对14.7%，P = 0.32）。大多数患者接受了更昔洛韦/缬更昔洛韦治疗，所有患者的再激活经治疗后均得到缓解，且无一例发生有症状的CMV感染。移植后100天内死亡的患者均未出现CMV再激活。对数秩检验显示，CMV再激活对患者的总生存期无影响（P值为0.29）。
在我们的队列中，ASCT后CMV再激活率为17.6%。淋巴瘤和MM患者的再激活率无差异。通过采用抢先治疗，我们队列中的任何患者均未记录到有症状的CMV感染。CMV再激活对ASCT后患者的生存无影响。
