Allogeneic bone marrow transplantation: implications of herpesvirus screening and diagnosis

Allogeneic bone marrow transplantation is used increasingly as a treatment for haematological diseases. Pre-transplant conditioning is necessary to eradicate the host immune response, and post-transplant immunosuppressive therapy is continued to prevent graft-versus-host disease. Thus, bone marrow transplant recipients are severely immunocompromised for a prolonged period. Herpesvirus infections are a common complication because they are ubiquitous, latent and may be transmitted in donations of bone marrow and blood. Screening for herpesvirus, and subsequent diagnosis, is important because infection or reactivation may be prevented by the prophylactic use of anti-viral agents, the passive transfer of immunoglobulin, vaccination and/or infection control measures, and progression of severe disease may be halted by the therapeutic use of anti-viral agents, especially when intervention is early.