INCREASED INCIDENCE OF CYTOMEGALOVIRUS (CMV) INFECTION AND CMV-ASSOCIATED DISEASE AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION FROM UNRELATED DONORS

Cytomegalovirus (CMV) infection and CMV-associated disease were monito red using the CMV antigenemia assay in 72 patients who received alloge neic bone marrow transplantation (BMT), and their incidences were comp ared between related and unrelated donor transplant patients, The inci dence of CMV infection after BMT was significantly higher in patients who received transplants from HLA-matched unrelated donors than from H LA-matched sibling donors (87% vs 53%, P < 0.05), CMV-associated disea se developed in 73% of unrelated and in 14% of sibling donor transplan t patients (P < 0.01), The peak levels of CMV antigenemia were signifi cantly higher in unrelated donors than in sibling donor transplant pat ients (16 vs 1 CMV antigen-positive cells per 50000 WBCs, P < 0.01), T he median number of CMV antigen-positive cells on first detection was also significantly higher in unrelated donor transplant patients (15 v s 1, P < 0.01), The detection of CMV antigen-positive cells preceded t he development of CMV-associated disease in 18% of unrelated donor tra nsplant patients, suggesting a lower predictive value of CMV antigenem ia for subsequent CMV-associated disease in unrelated donor BMT, Caref ul monitoring and further studies are needed for the early diagnosis a nd prevention of CMV-associated disease in unrelated donor BMT.