Developments in the treatment of post-transplant viral disease

Stem cell transplantation is a potentially curative procedure for many types of haemopoietic malignancy but is associated with a period of intense immunosuppression which may last for 1 to 2 years. During this time new viral infections or reactivation of endogenous, latent virus can lead to a variety of clinical symptoms which, together, make a significant contribution to the morbidity and mortality of the procedure. Improvements in viral detection, prophylaxis and treatment of established disease are helping to minimize the clinical impact of viral disease, but a definitive solution to this problem must await improvements in our ability to reconstitute an effective immune system. Each of the viruses implicated in post-transplant disease has a unique relationship with the host immune system, and there is every hope that improvements in our understanding of viral immunology will be translated into more effective clinical control.