Hebart H, Schröder A, Löffler J, Klingebiel T, Martin H, Wassmann B, Gerneth F, Rabenau H, Jahn G, Kanz L, Müller C A, Einsele H
Medizinische Universitätsklinik, Abteilung II, Kinderklinik, Institut für Medizinische Informationsverarbeitung, and Abteilung für Medizinische Virologie, Universität Tübingen, Germany.
J Infect Dis. 1997 Jun;175(6):1490-3. doi: 10.1086/516484.
Sensitive screening for cytomegalovirus (CMV) by polymerase chain reaction (PCR) following autologous bone marrow or peripheral blood progenitor cell transplantation has not been evaluated. In a three-center study, 98 autograft transplant recipients were prospectively screened for CMV infection by PCR and culture techniques. At a median of 20 days (range, 3-28) after transplantation, 21 (39.6%) of 53 CMV-seronegative patients were PCR positive for CMV, and at a median of 17 days (range, 7-84) after transplantation, 19 (42.2%) of 45 CMV-seropositive patients were PCR positive for CMV. Low-level DNAemia (1-10 fg CMV DNA/mL blood) occurred for 1 week in 31 patients but was never associated with CMV disease. Of 9 patients who presented with at least two consecutive positive PCR results, 1 developed CMV pneumonia. No patients died because of CMV disease. Screening for CMV infection by PCR had a negative predictive value of 100% (as also observed after allogeneic transplantation), but its positive predictive value was significantly lower.
自体骨髓或外周血祖细胞移植后通过聚合酶链反应（PCR）对巨细胞病毒（CMV）进行灵敏筛查尚未得到评估。在一项三中心研究中，对98名自体移植受者采用PCR和培养技术对CMV感染进行前瞻性筛查。在移植后中位时间20天（范围3 - 28天）时，53名CMV血清学阴性患者中有21名（39.6%）CMV的PCR检测呈阳性，在移植后中位时间17天（范围7 - 84天）时，45名CMV血清学阳性患者中有19名（42.2%）CMV的PCR检测呈阳性。31名患者出现低水平病毒血症（1 - 10 fg CMV DNA/毫升血液）持续1周，但从未与CMV疾病相关。在9名至少连续两次PCR结果呈阳性的患者中，1名发生了CMV肺炎。没有患者因CMV疾病死亡。通过PCR筛查CMV感染的阴性预测值为100%（同种异体移植后也观察到），但其阳性预测值显著更低。
