Evaluation of cytomegalovirus reactivation and disease inpatients undergoing allogeneic and autologous hematopoietic stem cell transplantation(HSCT)

Cytomegalovirus (CMV) infection is a common viral infection after HSCT and is an important cause of morbidity and mortality. This study was conducted to determine the frequency and to evaluate risk factors of CMV reactivation and disease in patients who underwent HSCT. The data of a total of 252 patients, including 62 patients who underwent allogeneic HSCT and 190 patients who underwent autologous HSCT, in Eskişehir Osmangazi University Medical Faculty Hospital Hematology Clinic Bone Marrow Transplantation Service were retrospectively analyzed. CMV reactivation was found to be 82.3% in patients who underwent allogeneic HSCT and 31.1% in patients who underwent autologous HSCT in the first 100 days after transplantation. The frequency of CMV reactivation, the peak level of CMV DNA and the need for preemptive treatment were found to be significantly higher in patients who underwent allogeneic HSCT compared to the autologous HSCT group. Long-term steroid use and development of graft versus host disrease (GVHD) were found to increase the risk of reactivation in the allogeneic HSCT group. While none of the patients developed CMV disease in the autologous HSCT group during the follow-ups, 2 (3.2%) patients developed CMV disease in the patients who underwent allogeneic HSCT. This result was evaluated as the success of close follow-up and preemptive treatment. No correlation was found between CMV reactivation and 30-day and 100-day mortality in either transplant group. In conclusion; CMV reactivation is common in the first 100 days in patients undergoing HSCT. The risk increases especially in the case of allogeneic HSCT, long-term steroid use and the development of GVHD. Early diagnosis and preemptive treatment approach significantly reduce morbidity and mortality. For this reason, it is important to know the risk factors, to follow the patients closely, and to initiate preemptive treatment at the appropriate time. Key Words: Hematopoietic stem cell transplantation, cytomegalovirus, preemptive treatment