CYTOMEGALOVIRUS MONITORING BY POLYMERASE CHAIN-REACTION OF WHOLE-BLOOD SAMPLES FROM PATIENTS UNDERGOING AUTOLOGOUS BONE-MARROW OR PERIPHERAL-BLOOD PROGENITOR-CELL TRANSPLANTATION

Sensitive screening for cytomegalovirus (CMV) by polymerase chain reac tion (PCR) following autologous bone marrow or peripheral blood progen itor cell transplantation has not been evaluated, In a three-center st udy, 98 autograft transplant recipients were prospectively screened fo r CMV infection by PCR and culture techniques. At a median of 20 days (range, 3-28) after transplantation, 21 (39.6%) of 53 CMV-seronegative patients were PCR positive for CMV, and at a median of 17 days (range , 7-84) after transplantation, 19 (42.2%) of 45 CMV-seropositive patie nts were PCR positive for CMV. Low-level DNAemia (1-10 fg CMV DNA/mL b lood) occurred for 1 week in 31 patients but was never associated with CMV disease. Of 9 patients who presented with at least two consecutiv e positive PCR results, 1 developed CMV pneumonia, No patients died be cause of CMV disease. Screening for CMV infection by PCR had a negativ e predictive value of 100% (as also observed after allogeneic transpla ntation), but its positive predictive value was significantly lower.