Is CMV PCR Monitoring Necessary in Patients with Hematological Malignancy Receiving Chemotherapy? A Prospective...

This study aimed to evaluate cytomegalovirus (CMV) monitoring results in adult patients with hematological malignancies, identify risk factors associated with CMV reactivation, and emphasize the importance of regular CMV DNA monitoring using polymerase chain reaction (PCR).

In this prospective single-center study, 316 adult patients with leukemia or lymphoma receiving chemotherapy without hematopoietic stem cell transplantation were included. CMV DNA levels were monitored twice weekly during chemotherapy. Clinical and laboratory data were reviewed and associations between CMV reactivation and clinical and demographic parameters, including age, sex, malignancy type, neutropenia duration, lymphocyte count, and co-infections, were analyzed to identify independent risk factors.

A total of 504 hospitalization episodes were recorded. CMV infection occurred in 9% of patients. CMV viremia was observed in 35 episodes, with 13 episodes showing both viremia and clinical CMV disease. Among the 13 cases of CMV disease, 4 were CMV retinitis and 9 CMV pneumonia. Antiviral therapy was administered in 29 episodes. Among 48 episodes of CMV viremia, 16 (33%) cases received preemptive therapy and 13 (27%) were treated for CMV disease. Post-neutropenia lymphopenia and concurrent infections were identified as independent risk factors for CMV reactivation.

This real-world study demonstrates that CMV infection is a significant threat during intensive chemotherapy in patients with hematological malignancies. Regular PCR-based CMV DNA monitoring allows early detection and timely intervention, potentially reducing morbidity and improving outcomes. These findings support routine CMV surveillance of high-risk hematological cases to enhance patient management and clinical care.