EFFECT OF CYTOMEGALOVIRUS-INFECTION ON 1-YEAR MORTALITY-RATES AMONG RECIPIENTS OF ALLOGENEIC BONE-MARROW TRANSPLANTS

The effect of cytomegalovirus (CMV) infection on 1-year mortality rate s among allogeneic bone marrow transplant recipients who are receiving a standard protocol as prophylaxis for CMV infection is unclear. We d etermined the risk factors for death within 1 year among 103 bone marr ow transplant recipients by performing a multivariate analysis. The re sults of donor and recipient CMV-serologies did not predict 1-year mor tality, although there was a trend towards higher mortality among CMV seropositive recipients who received marrow from seronegative donors ( P = .077). Multivariate analysis revealed that the factors independent ly associated with 1-year mortality were the development of CMV antige nemia (relative risk [RR] = 2.74; confidence interval [CI] = 1.28-5.86 ), bone marrow transplantation (BMT) from unrelated donors (RR = 3.20; CI = 1.30-7.92), and severe acute graft-versus-host disease (RR = 3.5 0; CI = 1.50-8.17). Although significant on univariate analysis, advan ced underlying disease before BMT and the development of active CMV di sease after BMT were not independent risk factors. In conclusion, the development of CMV antigenemia after BMT was associated with increased I-year mortality, while the development of active CMV disease was not . Reactivation of CMV infection may represent a marker of poor immune reconstitution or may contribute to further immunosuppression after BM T.