Zaia J A, Gallez-Hawkins G M, Tegtmeier B R, ter Veer A, Li X, Niland J C, Forman S J
Department of Pediatrics, City of Hope National Medical Center, Duarte, California 91010, USA.
J Infect Dis. 1997 Sep;176(3):782-5. doi: 10.1086/517301.
Late occurrence of cytomegalovirus (CMV) disease after day 100 after bone marrow transplantation has become an increasing problem; whether a quantitative measurement of CMV DNA in plasma by polymerase chain reaction (P-PCR) could be predictive of such disease was investigated. In a prospective study, 117 subjects undergoing allogeneic marrow transplantation were followed for 120 days with weekly CMV blood cultures, with day 35 bronchoalveolar lavage CMV cultures, with weekly CMV P-PCR, and with clinical follow-up for an additional 1-2 years. Despite preemptive ganciclovir, CMV disease occurred in 9% of subjects, with a median time of onset of 176 days. Quantitative CMV P-PCR was associated with the late development of CMV disease (P = .01). Of 43 subjects with positive P-PCR results, 23% developed CMV disease, but no disease occurred in the 74 subjects with negative P-PCR (P < .001), despite the fact that 22% had CMV isolated from lung lavage fluid and 32% had CMV isolated from blood.
骨髓移植100天后巨细胞病毒（CMV）疾病的晚期发生已成为一个日益严重的问题；研究了通过聚合酶链反应（P-PCR）对血浆中CMV DNA进行定量检测是否可预测此类疾病。在一项前瞻性研究中，对117例接受异基因骨髓移植的受试者进行了120天的随访，每周进行CMV血培养，在第35天进行支气管肺泡灌洗CMV培养，每周进行CMV P-PCR，并进行另外1至2年的临床随访。尽管采用了抢先使用更昔洛韦的治疗方法，但仍有9%的受试者发生了CMV疾病，发病中位时间为176天。CMV P-PCR定量检测与CMV疾病的晚期发生相关（P = 0.01）。在43例P-PCR结果为阳性的受试者中，23%发生了CMV疾病，但在74例P-PCR结果为阴性的受试者中未发生疾病（P < 0.001），尽管事实上22%的受试者肺灌洗液中分离出CMV，32%的受试者血液中分离出CMV。
