Gastrointestinal cytomegalovirus disease in patients with cancer: A two decade experience in a tertiary care cancer center

• Published in: European journal of cancer (1990) 2005-10, Vol.41 (15), p.2268-2279
• Main Authors: Torres, Harrys A., Kontoyiannis, Dimitrios P., Bodey, Gerald P., Adachi, Javier A., Luna, Mario A., Tarrand, Jeffrey J., Nogueras, Graciela M., Raad, Issam I., Chemaly, Roy F.
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - complications; Adult; Aged; AIDS; Antiviral Agents - therapeutic use; Biological and medical sciences; BMT; Cancer; Colitis; Cytomegalovirus; Cytomegalovirus Infections - complications; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - drug therapy; Drug Combinations; Endoscopy, Gastrointestinal - methods; Female; Gastritis; Gastrointestinal Diseases - complications; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - drug therapy; Graft vs Host Disease - etiology; Hematopoietic Stem Cell Transplantation; HIV; HSCT; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasms - complications; Neoplasms - drug therapy; Pharmacology. Drug treatments; Retrospective Studies; Tumors
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2005.07.011

Although gastrointestinal cytomegalovirus disease (GI-CMVd) is not common in cancer patients, it is associated with high morbidity and mortality. Herein, we review our 2-decade experience with GI-CMVd in such patient population at The University of Texas M.D. Anderson Cancer Center. Forty-seven patients were identified. Thirty-four patients (72%) had an underlying haematological malignancy, and 18 patients (38%) developed GI-CMVd following hematopoietic stem cell transplantation (HSCT). Nine (25%) of the 36 cancer patients with data available had AIDS. Upper-GI tract involvement was more common in patients with haematological malignancies than in those with solid tumours ( P = 0.02). Patients with AIDS were more likely to have colonic involvement than were those without AIDS (67% vs. 15%, P = 0.006), and patients without AIDS were more likely to have gastric involvement (59% vs. 11%, P = 0.01). The CMV-attributable mortality rate was 42%. Independent predictors of death by multivariate analysis included disseminated CMV and AIDS ( P < 0.01). The presentation of GI-CMVd varies according to the type of cancer, and AIDS. GI-CMVd is associated with a high mortality among cancer patients, particularly those with disseminated CMV disease or AIDS.