[Clinical features of cytomegalovirus pneumonia after allogeneic hematopoietic stem cell transplantation]

To analyze the clinical features and prognosis of cytomegalovirus (CMV) pneumonia after allogeneic hematopoietic stem-cell transplantation (allo-HSCT) under the preemptive therapy based on monitoring CMV-DNA level quantificationally.

We studied 750 patients underwent allo-HSCT from Jan, 2005 to Aug, 2008. A total of 22 patients who developed into CMV pneumonia were analyzed retrospectively.

Twenty-four episodes of CMV pneumonia occurred in the 22 patients (2.9%) and the majority of them developed into CMV pneumonia average 51 days ( 30 to 180 days) after allo-HSCT. Of the 22 patients 16 (72.7%) underwent CMV-DNA emia and 6 remained CMV-PCR negative throughout the course of the disease. The pulmonary CT manifestation of 23 episodes showed specific features of interstitial changes, including diffused or patchy ground-glass opacities. Better curative effects were obtained using antivirus drugs combined with glucocorticoid and the total curative ratio of CMV pneumonia was 83.3%. Male and the occurrence of severe acute graft-versus-host disease seemed to be correlated with an unfavorable outcome through univariate analysis(P=0.034, P=0.023).

Making a diagnosis as soon as possible and appropriate therapy will improve the outcome of patients with CMV pneumonia markedly.