CMV monitoring after peripheral blood stem cell and bone marrow transplantation by pp65 antigen and quantitative PCR

We prospectively monitored 74 consecutive allogeneic and 50 autologous pati ents after bone marrow/stem cell transplantation from May 1999 to October 2 000 at our institution with quantitative CMV PCR and pp65 antigen assay onc e weekly from conditioning therapy to days 120 and 80 after transplantation , respectively. Written informed consent was obtained from every patient. C MV prophylaxis consisted of acyclovir during transplant. Additionally all p atients received only platelet products from CMV-negative donors. In the ca se of CMV infection preemptive therapy with gancyclovir was applied. In the case of CMV disease high-dose immunoglobulin was given as well. In the all ogeneic setting 16 out of 74 (22%) patients developed a positive PCR. Seven episodes of a positive pp65 antigen assay occurred in six allograft recipi ents. In the autologous setting no positive assay was found during the whol e observation period. Additionally, in 6/16 patients a lymphoproliferative assay was performed during CMV infection. Two patients showed a positive (1 5 and 5.4) and four a negative (2,1.6,1,1.8) stimulation index.