Cytomegalovirus Infection Causes Delayed Platelet Recovery After Bone Marrow Transplantation

• Published in: Blood 1991-08, Vol.78 (3), p.844-848
• Main Authors: Verdonck, Leo F., Gast, Gijsbert C. de, Heugten, Hans G. van, Nieuwenhuis, H.Karel, Dekker, Adriaan W.
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Transfusion; Bone Marrow Transplantation - physiology; Cytomegalovirus Infections - etiology; Female; Hematopoiesis; Histocompatibility Testing; Hodgkin Disease - surgery; Humans; Intensive care medicine; Leukemia, Myeloid, Acute - surgery; Lymphoma, Non-Hodgkin - surgery; Male; Medical sciences; Platelet Count; Precursor Cell Lymphoblastic Leukemia-Lymphoma - surgery; Retrospective Studies; Time Factors; Transplantation, Autologous; Transplantation, Homologous
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood.V78.3.844.844

The pathogenic effect of cytomegalovirus (CMV) infection on the hematopoietic recovery after bone marrow transplantation (BMT) was retrospectively studied in 87 recipients of (nonpurged) autologous BMT and in 56 recipients of allogeneic BMT from HLA-identical siblings. Indications for autologous BMT were lymphomas or acute leukemias and for allogeneic BMT various malignancies or aplastic anemia. Patients were divided for the study in two groups, CMV-positive and CMV-negative on the basis of the CMV status pretransplant, and CMV-negative patients were kept CMV-negative by the local transfusion policy. In allogeneic BMT recipients, platelet recovery was significantly slower in CMV-positive patients than in CMV-negative patients (platelets > 50,000 cells/μL after 41 days v 27 days, P = .007). This difference held true when patients With acute graft-versus-host disease above grade I were excluded (platelets > 50,000 cells/μL after 42 days v 24 days, P = .01). In autologous BMT, the negative effect on platelet recovery was present in patients with lymphomas, but absent in patients with acute leukemias. Patients with acute leukemias had a very delayed recovery of platelets and granulocytes after autologous BMT, irrespective of the CMV status, probably due to the original stem cell disorder. Platelet recovery was significantly slower in CMV-positive autologous BMT recipients with lymphomas than in those not infected (platelets > 50,000 cells/ΜL after 36 days v 24 days, P = .0002). The presence of CMV infection had no effect on the recovery of granulocytes in autologous or allogeneic BMT. These data show that CMV infection causes delayed platelet recovery after BMT; however, in autologous BMT, the underlying disease (ie, acute leukemia) is more determinant for hematopoiesis after BMT.