Work

Cytomegalovirus DNAemia in the lower respiratory tract in nontransplant patients with hematologic malignancies

Year: 2025

Type: article

Abstract: OBJECTIVES: Cytomegalovirus (CMV) pneumonia is a serious complication in immunocompromised patients, but its role in non-transplant populations remains unclear. METHODS: We analyzed CMV DNA in bronchoalveolar lavage (BAL) samples from 100 non-transplant adult patients with hematologic malignancies hospitalized for lower respiratory tract infections (LRTI) between 2022 and 2024. RESULTS: CMV DNA was detected in 13% of 108 BAL samples, exclusively in patients with lymphoid diseases, where the detection rate was 20%. Median BAL viral load (VL) was 4151 IU/ml (256-810 000 IU/ml). In 4 (28%) cases concomitant blood CMV viremia was observed (642 IU/ml, 331- 149 000 IU/ml), with no correlation between blood and BAL VL. Co-pathogens included bacteria (28%), fungal antigens (36%), respiratory viruses (36%), and herpesviruses (21%). Computed tomography findings frequently showed consolidations and ground-glass opacities. All patients with BAL DNAemia received antiviral therapy. Viral load thresholds did not predict severity and outcomes and CMV DNAemia did not increase non-relapse mortality by day 180. CONCLUSIONS: CMV DNAemia is not uncommon in BAL samples from patients with lymphoid malignancies and often coexists with other pathogens. This group remains underrepresented in current guidelines, with undefined risk factors, outcomes, and diagnostic criteria.

Source: International Journal of Infectious Diseases

DOI: 10.1016/j.ijid.2025.108231

Authors: Alicja Sadowska-Klasa, Karolina Bełdzińska-Gądek, Kaja Klein-Awerjanow, Łukasz Naumiuk, Jan Maciej Zaucha

Institutions: University Clinical Centre, Gdańsk Medical University

Language: English

Topic: Cytomegalovirus and herpesvirus research

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,900