Polymerase chain reaction monitoring reduces the incidence of cytomegalovirus disease and the duration and side effects of antiviral therapy after bone marrow transplantation

摘要: Culture-based preemptive therapy with ganciclovir was shown to reduce the incidence of cytomegalovirus (CMV) disease after bone marrow transplantation (BMT). Culture techniques did not detect CMV in 12% 13% patients before onset disease. In a prospective study, 71 either received based on polymerase chain reaction (PCR) technique (37 patients) or culture assays (34 patients). both groups, continued until clinical signs disappeared and PCR negativity documented. Twenty-two group 15 antiviral therapy. allowed detection virus (median day, +32 v day +49; P = .006) introduction +44 +54; .02) earlier than assays. The incidences (2 37 8 34 group, respectively; CMV-associated mortality (0 5 were decreased, duration (P < .001) shorter PCR-monitored group. Incidence median severe neutropenia (less 500/microL) lower (two eight episodes, .02; duration, 1.5 days, .04), as nonviral infections during/after 9 34; .012). Thus, more sensitive methods such assay reduces CMV-related mortality. Additionally, stopping withholding PCR-negative patient is safe allows reduction side effects