Cytomegalovirus reactivation after autologous stem cell transplantation in myeloma and lymphoma patients: A single-center study

Table 2 Clinical and laboratory features and outcome of cytomegalovirus reactivation episodes requiring specific antiviral treatment (36/327, 11%)

Clinical and laboratory features	No. of cases
Fever (temperature > 38 °C persistent at least 60 min)	36 (100%)
Signs of bone marrow suppression (delay of neutrophilis and/or platelet recovery or drop in neutrophilis and/or platelet count after recovery)	35 (97%)
DNAemia positivity (PCR assay)	36 (100%)
End-organ disease (according to published criteria)	4 (11%)
Interstitial pneumonia	3
Enteritis	1
Median number of CMV copies at first detection (range)1	895 (188-10120)
Median day from transplant at first detection (range)	33 (12-77)
Pre-transplant CMV IgG seropositivity	36 (100%)
Outcome
Treatment2
Ganciclovir	8
Foscarnet sodium	16
Valganciclovir	12
Immunoglobulins	4
Need of hospital admission	20 (55%)
Hematological recovery, median (range)3
Neutrophilis > 500/mcL	14 (10-25)
Platelets > 20000/mcL	20 (11-88)
Alive	33 (92%)
Dead (48, 62, 89 d from transplant)	3 (8%)

¹Limit of detection of PCR testing: 88 copies/mL;

²Foscarnet sodium dosage: 60 mg/kg twice daily for 14 d, than 60 mg/kg per day for subsequent 5 d weekly for 2 wk); Ganciclovir dosage: 5 mg/kg twice daily for 14 d, than 5 mg/kg per day for subsequent 5 d weekly for 2 wk; Valganciclovir dosage: 900 mg twice daily for 14 d, than 900 mg/d for subsequent 5 d weekly for 2 wk;

³The occurrence of a symptomatic CMV reactivation after ASCT, requiring antiviral treatment, leads to a delay in neutrophilis and platelets recovery (P = 0.003 and P = 0.001 respectively). ASCT: Autologous hematopoietic stem cell transplantation; CMV: Cytomegalovirus.