A COMPARISON OF THE PATTERN OF INTERSTITIAL PNEUMONITIS FOLLOWING ALLOGENEIC BONE-MARROW TRANSPLANTATION BEFORE AND AFTER THE INTRODUCTION OF PROPHYLACTIC GANCICLOVIR THERAPY IN 1989

A comparison was made of the pattern of interstitial pneumonitis (IF) following allogeneic bone marrow transplantation before and after the introduction of ganciclovir prophylaxis to minimize the risk of cytome galovirus (CMV) disease in the St Vincent's Hospital bone marrow trans plant program in 1989. A total of 456 recipients of allogeneic transpl ants were included, 280 received no prophylactic ganciclovir while 176 received prophylactic ganciclovir. The overall incidence of interstit ial pneumonitis dropped from 19.6 to 12.5% (P = 0.03) and this was pri marily due to a reduction in the incidence of CMV-LP which fell from 1 2.9 to 1.7% (P < 0.0005). The incidence of idiopathic IP was not diffe rent between the two groups (6.3 vs 3.2 %), nor was the incidence of P neumocystis carinii pneumonia (2.9 and 0.6%), Prophylactic ganciclovir has thus had a significant impact in reducing both the overall incide nce of IP and specifically cytomegalovirus IP in allogeneic marrow tra nsplant recipients, The most common form of IP in patients given proph ylactic ganciclovir is now idiopathic interstitial pneumonitis.