UNUSUAL INFECTIONS FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR CHRONIC LYMPHOCYTIC-LEUKEMIA

Unusually severe infectious phenomena were observed in three patients with chronic lymphocytic leukemia (CLL) who had undergone allogeneic b one marrow transplantation (BMT) from matched sibling donors. The firs t developed three episodes of cytomegaloviremia requiring anti-viral t herapy; the third episode accompanied by cytomegalovirus hepatitis whi ch required prolonged therapy with foscarnet. Another had Listeria mon ocytogenes meningitis which was difficult to eradicate and required pr olonged maintenance antimicrobial therapy with oral trimethoprim-sulfa methoxazole and intrathecal gentamicin until death due to chronic graf t-versus-host disease, The third patient had cytomegaloviremia lasting 47 days, which did not clear within 4 weeks of full-dose ganciclovir, Although the number of patients is small, in our experience the probl ems encountered were unusually severe compared with patients allograft ed for other diseases. We conclude that CLL patients undergoing alloge neic BMT may be at a higher risk of infectious complications than pati ents allografted for other diseases, and require careful monitoring.