TREATMENT OF INTERSTITIAL PNEUMONITIS DUE TO CYTOMEGALOVIRUS WITH GANCICLOVIR AND INTRAVENOUS IMMUNE GLOBULIN - EXPERIENCE OF EUROPEAN BONE-MARROW TRANSPLANT GROUP
P. Ljungman et al., TREATMENT OF INTERSTITIAL PNEUMONITIS DUE TO CYTOMEGALOVIRUS WITH GANCICLOVIR AND INTRAVENOUS IMMUNE GLOBULIN - EXPERIENCE OF EUROPEAN BONE-MARROW TRANSPLANT GROUP, Clinical infectious diseases, 14(4), 1992, pp. 831-835
Data on 49 allogenic bone marrow transplant (BMT) recipients who devel
oped interstitial pneumonia due to cytomegalovirus (CMV) were collecte
d retrospectively. All patients were treated with ganciclovir and high
doses of intravenous immune globulin, although types of immune globul
ins and schedules of treatment varied. Seventeen (35%) of 49 patients
responded to treatment. Thirty days after the diagnosis of interstitia
l pneumonia, the survival rate among patients was 31%. CMV was detecte
d in 81% of patients on whom autopsies were performed. The survival ra
te among patients who received total body irradiation (TBI) was signif
icantly lower (11[27%] of 41) than that among patients who did not rec
eive TBI (six[75%] of eight; odds ratio = 12.3; P = .009). No other fa
ctor, including age, grade of graft-versus-host disease, types and dos
e of immune globulin used, or dose of ganciclovir, was correlated to s
urvival. These results show that although survival of allogeneic BMT r
ecipients with CMV interstitial pneumonia has improved, more than one-
half of the patients still died of pneumonia. Thus, both prophylaxis f
or and treatment of CMV infection must be improved.