Cytomegalovirus infection and non-neutropenic fever after autologous stem cell transplantation: high rates of reactivation in patients with multiple myeloma and lymphoma

Br J Haematol. 2001 Jan;112(1):237-41. doi: 10.1046/j.1365-2141.2001.02487.x.

Abstract

In a retrospective study, we examined the association between cytomegalovirus (CMV) infection and non-neutropenic fever immediately following autologous peripheral blood stem cell transplantation for a variety of haematological malignancies and solid tumours. Sixty non-neutropenic febrile episodes (41 in CMV-seropositive and 19 in CMV-seronegative patients) were evaluated. CMV reactivation, documented by CMV antigenaemia, was detected in 16 out of 41 (39%) seropositive patients compared with 0 out of 19 seronegative patients. In 12 of these 16 patients, CMV infection was considered the sole cause of fever. Thirteen patients had maximum antigenaemia levels > 5 cells/slide. Specific antiviral treatment led to the resolution of the fever in all, but two, patients, who developed fatal CMV pneumonia. Patients with multiple myeloma and lymphoma, possibly owing to a combination of disease-related characteristics and prior immunosuppressive treatment, had high rates of CMV reactivation and may require more frequent diagnostic evaluation and prompt therapeutic intervention.

MeSH terms

  • Adult
  • Aged
  • Antigens, Viral / blood
  • Antiviral Agents / therapeutic use
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / complications*
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / drug therapy
  • Female
  • Fever / drug therapy
  • Fever / virology*
  • Foscarnet / therapeutic use
  • Ganciclovir / therapeutic use
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Lymphoma / surgery*
  • Lymphoma / virology
  • Male
  • Middle Aged
  • Multiple Myeloma / surgery*
  • Multiple Myeloma / virology
  • Postoperative Complications / drug therapy
  • Postoperative Complications / virology*
  • Retrospective Studies
  • Transplantation, Autologous
  • Virus Activation

Substances

  • Antigens, Viral
  • Antiviral Agents
  • Foscarnet
  • Ganciclovir