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2015 ; 5
(4
): 287-91
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Cytomegalovirus infection in the bone marrow transplant patient
#MMPMID26722656
Bhat V
; Joshi A
; Sarode R
; Chavan P
World J Transplant
2015[Dec]; 5
(4
): 287-91
PMID26722656
show ga
Cytomegalovirus (CMV) infection is an important contributor to the morbidity and
mortality associated with bone marrow transplantation (BMT). Infection may lead
to CMV disease involving multiple organs such as pneumonia, gastroenteritis,
retinitis, central nervus system involvement and others. CMV seropositivity is an
important risk factor and approximately half of BMT recipients will develop
clinically significant infection most commonly in the first 100 d
post-transplant. The commonly used tests to diagnose CMV infection in these
patients include the pp65 antigenemia test and the CMV DNA polymerase chain
reaction (PCR) assay. Because of its greater sensitivity and lesser turnaround
time, the CMV PCR is nowadays the preferred test and serves as a main guide for
pre-emptive therapy. Methods of CMV prevention include use of blood products from
seronegative donors or leukodepleted products. Prophylaxis or pre-emptive therapy
strategies for CMV prevention may be used post-transplant with the latter
becoming more common. The commonly used antivirals for pre-emptive therapy and
CMV disease management include intravenous gancyclovir and foscarnet. The role of
intravenous immunoglobulin, although used commonly in CMV pneumonia is not clear.