Cytomegalovirus pneumonia in adults with leukemia: An emerging problem

Cytomegalovirus (CMV) pneumonia is reportedly unusual among adults with leu kemia who have not undergone transplantation. To assess the frequency of CM V pneumonia and its outcome during the present time, we reviewed the experi ence of 2136 hospitalized adults with leukemia. Sixty-one patients (2.9%) h ad CMV pneumonia diagnosed. The frequency doubled from 1.4% in 1992-1994 to 2.8% in 1995-1997 (P<.05). Fifty-four patients (89%) had received treatmen t with an immunosuppressive chemotherapeutic regimen that contained fludara bine (n = 37), high-dose cytoxan (n = 17), or both (n = 10), and 15 patient s (25%) had received granulocyte transfusions that were stimulated with hem atopoietic growth factors from unscreened donors. The overall CMV pneumonia -associated mortality rate was 57%. Among autopsied patients who had leukem ia, the frequency of CMV pneumonia increased from 0%, 2.3%, and 0% in 1992, 1993, and 1994, respectively, to 4.6%, 6.5%, and 16% in 1995, 1996, and 19 97, respectively (P<.05). CMV has emerged as an important cause of life-thr eatening pneumonia in adults with leukemia who have received potent immunos uppressive therapies and stimulated granulocyte transfusions from unscreene d donors.