Prophylaxis of cytomegalovirus infection after bone marrow transplantation

Viral infections occur frequently during the reconvalescence phase of allogeneic bone marrow transplantation due to the persistence of severe immunodeficiency. Recent advances in the treatment of cytomegalovirus-associated interstitial pneumonia have resulted in the development of an effective strategy for the prevention of this disease. Cytomegalovirus infection as determined by rapid culture from prospective bronchoalveolar lavage specimens on day +35 has been identified as a formidable risk factor for the development of pneumonia. Preemptive therapy with ganciclovir alone prevents the evolution from infection to pneumonia in this subgroup while protecting most other patients from unnecessary drug exposure.