Year: 2019
Type: article
Study design: Observational Study
Abstract: Introduction CMV infection remains a leading cause of morbidity and mortality in allogeneic hematopoietic cell transplant (allo-HCT) recipients. CMV can cause tissue-invasive disease, especially pneumonitis, with poor outcomes. Methods We performed a retrospective study in HCT recipients who had CMV pneumonia from January 2014 to August 2018. The microbiology laboratory records were queried to identify patients with CMV pneumonia based on CMV viral culture and CMV real time-PCR in bronchoalveolar lavage (BAL). Data on demographics, clinical characteristics, management and mortality were collected. Results A total of 35 patients were diagnosed with CMV pneumonia and 16 (47%) were male, with a median age of 56 years (range: 18-83). The median time from HCT to CMV pneumonia was 141 days (range 25-1579); the majority occurred after day 100 (60%). All patients except one were CMV seropositive and 15/31 (48%) had GVHD at time of diagnosis. The median plasma CMV viral load (VL) at diagnosis was 137 UI/mL (range: 0-6.586) while the median VL in BAL was 1.700 UI/mL (range 79-64.800) (Figure). Foscarnet was the most common antiviral agent used (23, 70%) followed by ganciclovir (16, 48%). Twenty (61%) patients received combination therapy with IVIGs with a mean number of doses of 4.35 (range: 1-17). All-cause mortality was 80% and CMV-associated mortality was 66%. Systemic steroids (75%), co-infections after diagnosis of CMV pneumonia (37%) and mechanical ventilation (82%) were associated with mortality death. Conclusion CMV pneumonia remains a significant cause of mortality after HCT and most occurred after day 100.
Institution: The University of Texas MD Anderson Cancer Center
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,650
OpenAlex ID: W2912616384