Reduced risk of persisting cytomegalovirus pp65 antigenemia and cytomegalovirus interstitial pneumonia following allogeneic PBSCT

In order to evaluate the risk of cytomegalovirus (CMV) associated disease a fter allogeneic stem cell transplantation (SCT), 158 consecutive patients a t risk for infection were analyzed. BMT was performed in 101 patients and p eripheral blood stem cell transplantation (PBSCT) in 57 patients. CMV antig enemia was found in 57 cases (56%) after BMT and 27 cases (47%) after PBSCT , respectively. CMV antigenemia resistant to a 14-day course of GCV was fou nd in 26 patients (26%) after BMT but in only four patients (7%) after PBSC T (P < 0.01). Eighteen patients (11%) developed CMV disease, 14 post BMT an d four post PBSCT, Lethal CMV-related interstitial pneumonia (CMV-TP) occur red in 13 cases of whom 13 patients were bone marrow recipients (P = 0.04). The subgroup of seronegative patients with a CMV seropositive donor had a significantly lower risk of developing CMV antigenemia, GCV-resistant CMV a ntigenemia (P < 0.01) and CMV-related disease (P = 0.01). In conclusion, th e incidence of persistent CMV antigenemia and CMV-IP was significantly redu ced when allogeneic transplantation was performed with peripheral blood ste m cells instead of bone marrow, These findings suggest that our previous in vitro data on improved immune reconstitution after allogeneic PBSCT as com pared to allogeneic BMT have clinical relevance.