Molecular Epidemiology of Cytomegalovirus Infections Associated with Bone Marrow Transplantation

Abstract

Restriction endonuclease analysis of purified viral DNA was used to study the molecular epidemiologic characteristics of cytomegalovirus infection in 18 patients having bone marrow transplantation. Four patients who had had asymptomatic excretion of cytomegalovirus in urine before transplantation subsequently developed a cytomegalovirus infection after transplantation (pneumonia in 2 patients, fever and viremia in 1 patient, and asymptomatic viruria in 1 patient). In each patient, the infection that developed after transplantation was caused by a cytomegalovirus strain genetically identical to the isolate detected in urine before transplantation. Cytomegalovirus isolates from different sites (buffy coat, lung, and urine) of the same patient were also identical, but cytomegalovirus isolates from different patients were never identical. Our results suggest that some cytomegalovirus infections after bone marrow transplantation may be caused by strains present before transplantation. The great structural and genetic variability of cytomegalovirus isolates must be considered in the development of effective diagnostic and immunoprophylactic measures for infection after marrow transplantation.

Late diversification in the clonal composition of human cytomegalovirus-specific CD8+ T cells following allogeneic hemopoietic stem cell transplantation

“…Most active HCMV infections observed in the recipient after alloSCT are the result of reactivation of latent virus in HCMV-seropositive recipients. 26 Among HCMV-seronegative recipients who receive hemopoietic allografts from HCMVseropositive donors and who receive only HCMV-seronegative blood products, the incidence of HCMV infection (with or without seroconversion) is relatively low, only 17%. 27 We studied HCMVseronegative recipients 06 to 08 who received allografts from HCMV-seropositive donors; these recipients had no serologic evidence or evidence of HCMV DNAemia (on weekly monitoring continued until cessation of immunosuppression) after alloSCT.…”

CMV-specific immune reconstitution following allogeneic stem cell transplantation

“…[65][66][67] This explains the differential risk according to donor and recipient serotype. The highest risk group is seropositive recipients (RC) with seronegative donors (D¡) in which reactivation occurs in up to 80% of cases.…”

Cytomegalovirus gB Genotype Distribution in Mexican Children Undergoing Allogeneic Bone Marrow Transplantation

“…Our findings suggest that these patients were infected before undergoing ABMT and, with the graft of stem cells, they became reinfected with new strains, leading to AI with a mixture of genotypes. However, this is possible in only some but not in all cases because CMV reactivation in patients undergoing ABMT can be endogenous [14] .…”