ASSOCIATION OF SPECIFIC CYTOMEGALOVIRUS GENOTYPES WITH DEATH FROM MYELOSUPPRESSION AFTER MARROW TRANSPLANTATION

A retrospective analysis of cytomegalovirus (CMV) genotype was conduct ed on 281 CMV isolates obtained from marrow transplant recipients. The genotyping was based on sequence variations in the gene encoding enve lope glycoprotein B (gB) as detected by restriction analysis of polyme rase chain reaction (PCR)-amplified gB DNA. Among all isolates studied , the distribution of gB types 1-4 was 48.4%, 16.4 %, 24.6%, and 8.2%, respectively, with only 2.5% of all isolates containing more than one gB type, The association of gB types with acute graft-versus-host-dis ease (GVHD) and death related to myelosuppression was examined using a ppropriate multivariable regression models. Covariables in addition to gB type included underlying disease type, donor-recipient HLA matchin g, donor CMV serostatus, and age as a continuous variable. Death assoc iated with myelosuppression occurred in 2.9% or 4 of 136 patients with gB1, 0% or 0 of 46 patients with gB2, 21.7% or 15 of 69 patients with gB3, and 17.4% or four of 23 patients with gB4. The significant assoc iation of CMV gB type with death due to myelosuppression was maintaine d in a multivariable analysis (P <.001). In addition, the data also su ggested that gB types 3 and 4 may be associated with a reduced hazard of grades II to IV acute GVHD, (C) 1997 by The American Society of Hem atology.