QUANTIFICATION OF CMV VIREMIA IN A CASE OF TRANSFUSION-RELATED GRAFT-VERSUS-HOST DISEASE-ASSOCIATED WITH PURINE ANALOG TREATMENT

We report a patient who developed transfusion-associated graft-versus- host-disease (GvHD) and concurrent cytomegalovirus (CMV) infection, bo th complications thought to be related to severe T lymphocyte depletio n induced by treatment with a purine analogue drug, fludarabine. CMV v iraemia was detected by qualitative PCR and the viral load in positive samples was measured using a fully quantitative PCR assay. This quant itative assay enabled the evaluation of the efficacy of antiviral inte rventions based on the qualitative PCR result. The case illustrates th e risks associated with the use of purine analogue drugs, as well as t he value of quantitative CMV PCR assays for monitoring CMV infection i n immunocompromised patients.