USE OF A SEMIQUANTITATIVE PCR FOR CYTOMEGALOVIRUS DNA AS A BASIS FOR PREEMPTIVE ANTIVIRAL THERAPY IN ALLOGENEIC BONE-MARROW TRANSPLANT PATIENTS

The aim of this study was to evaluate the efficacy of pre-emptive anti viral therapy, based on a semi-quantitative nested PCR for cytomegalov irus (CMV) DNA in leukocytes, for the prevention of CMV disease after allogeneic BMT, Fifty-eight patients were prospectively followed with PCR for CMV DNA and antiviral therapy with ganciclovir was initiated a fter two consecutive positive tests, The levels of CMV DNA were determ ined by serial dilutions of the positive samples, The probability of d etection of CMV DNA was 48.3% and the probability of CMV disease 6% at 100 days after BMT, Patients with CMV disease had higher CMV DNA leve ls compared with patients without CMV disease (P = 0.001), In comparis on to 58 matched historical controls detection of CMV DNA was 5 days e arlier (NS) and antiviral therapy could be initiated 10 days earlier i n patients followed by PCR (P = 0.05), Pre-emptive antiviral therapy w as given to 28 patients in a total of 36 courses, Patients became nega tive in PCR after 28 of 36 courses (77%), We conclude that PCR for CMV DNA can be used for early detection of CMV infection and as the basis for initiation of pre-emptive antiviral therapy in BMT patients.