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Viral Infections

Cytomegalovirus pneumonia in adult autologous blood and marrow transplant recipients

Bone Marrow Transplantation volume 27, pages 877–881 (2001)Cite this article

Abstract

CMV pneumonia is a major cause of morbidity and mortality among allogeneic BMT recipients. To assess the frequency, timing, risk factors and response to therapy of CMV pneumonia among autologous BMT recipients, we reviewed our experience with 795 patients. Sixteen (2%) patients were diagnosed with CMV pneumonia. The frequency was higher among patients who were seropositive than those who were seronegative (3.3% vs 0%, P = 0.008). Among seropositive patients, the frequency was higher among patients with hematological malignancies than patients with solid tumors (5.0 % vs1.0%, P = 0.019). Eleven cases occurred <30 days, and five cases occurred >100 days post transplant. The overall CMV pneumonia-related mortality rate was 31%. Seven (78%) of nine patients treated with ganciclovir and IVIG prior to respiratory failure survived; neither of two patients treated after respiratory failure survived. Four of five (80%) untreated patients survived. In conclusion, CMV is a not infrequent cause of pneumonia among autologous BMT recipients. Risk factors include CMV seropositivity and an underlying hematological malignancy. A favorable response hinges on the prompt initiation of therapy. The survival of 25% of the patients without antiviral therapy suggests that the isolation of CMV from a BAL specimen occasionally reflects oropharyngeal contamination or that CMV pneumonia may sometimes be self-limited in more immunocompetent autologous BMT recipients. Bone Marrow Transplantation (2001) 27, 877–881.

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Authors and Affiliations

  1. Department of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    S Konoplev, RE Champlin, S Giralt, NT Ueno & I Khouri

  2. Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    I Raad, K Rolston, K Jacobson, Q Nguyen & E Whimbey

  3. Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    J Tarrand

  4. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    M Luna

Authors
  1. S Konoplev
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  2. RE Champlin
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  3. S Giralt
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  4. NT Ueno
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  5. I Khouri
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  6. I Raad
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  7. K Rolston
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  8. K Jacobson
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  9. J Tarrand
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  10. M Luna
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  11. Q Nguyen
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  12. E Whimbey
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Konoplev, S., Champlin, R., Giralt, S. et al. Cytomegalovirus pneumonia in adult autologous blood and marrow transplant recipients. Bone Marrow Transplant 27, 877–881 (2001). https://doi.org/10.1038/sj.bmt.1702877

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  • DOI: https://doi.org/10.1038/sj.bmt.1702877

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