Cytomegalovirus Infection Monitoring In Patients With Long-term Survival After Allogeneic Hematopoietic Stem Cell Transplantation

Objective:To analyze the cytomegalovirus (CMV) infection status and the risk factors in patients with long-term survival after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:159long-term survivors receive allo-HSCT from January2008through December2011in the Bone Marrow Transplantation Center of Zhejiang University were included, CMV pp65antigen in peripheral blood leukocytes was detected by immunofluorescence assay at regular intervals, to retrospectively analyzed the clinical data.Results:A total of159patients with long-term survival at18-66months after allo-HSCT were investigated. And8,047specimens were detected, including2,553positive samples. All patients were at least one time positive for CMV-pp65antigen after allo-HSCT. The CMV antigen positive rate increased gradually from100days after transplantation to within100days until1year while the positive rate decreased, after1year. The difference was statistically significant (P<0.01). The CMV antigen positive rate in patients after non-myeloablative allo-HSCT (NST) and those after myeloablative allo-HSCT were167/608(27.5%) and2386/7439(32.1%) respectively. The difference was statistically significant (P=0.019). No statistically significant difference existed between those with acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD)(P>0.05). The CMV antigen positive rate in patients with â… -â…¡ grade aGVHD and those with â…¢-â…£ grade aGVHD were1017/3284(31.0%) and227/641(35.4%) respectively. And it had statistically significant difference (P=0.027). By univariate and multivariate analysis,the none-use of ATG and â…¢-â…£ grade aGVHD were the risk factors for CMV antigen positive after allo-HSCT (all P<0.05).Conclusions:Regular monitoring of CMV-pp65antigen after allo-HSCT is quite necessary for prevent and treat CMV infection in a timely manner. The CMV infection in long-term survival patients may be related to the selection of conditioning regimen, it has no obvious correlation with the incidence of GVHD, but it is associated with the severity of aGVHD.