Allogeneic Hematopoietic Stem Cell Transplantation In Patients With Cmv Infection In Early Detection And Prevention

Objective To evaluate the clinical significance of Real-time Quantitative Polymerase Chain Reaction ( Real-time Q-PCR) in monitoring Cytomegalovirus (CMV) infection after Allogeneic Hematopoietic Stem Cell Transplantation ( allo-HSCT) , and seek for the effective method of detecting and managing CMV infection.Methods Real-time Q-PCR was performed for monitoring CMV infection in 15 recipients since -15d . Ganciclovir and foscarnet are the approved drugs for treating CMV disease. Either alone in combination with intravenous immunoglobulin had been used for prevention .The two drugs and immunoglobulin had been used in combination as therapy for established CMV disease .Results There were not CMV-DNA detected in both 15 recipients and donors before allo-HSCT, and the monitoring tests were also negative after allo-HSCT. But One patient presented typical symptoms of CMV Pneumonitis despite a negative PCR assay, in this case, PP65 antigenemia was found to be positive. Another patient was suspected to have CMV cystitis , but several detecting results wre all negative .Conclusion To allo-HSCT recipients the Real-time Q-PCR based on blood is not correlated well with CMV disease. This is due to the immunosuppress, bone marrow suppression and low virus load. So appropriate samples and detecting methods should be used accordingly . It's important to initiate preemptive therapy when CMV-DNA is positive or patients have high CMV risk factors .