Table 2.
Clinical and laboratory features and outcome of cytomegalovirus reactivation episodes requiring specific antiviral treatment (36/327, 11%)
| Clinical and laboratory features | No. of cases |
| Fever (temperature > 38 °C persistent at least 60 min) | 36 (100%) |
| Signs of bone marrow suppression (delay of neutrophilis and/or platelet recovery or drop in neutrophilis and/or platelet count after recovery) | 35 (97%) |
| DNAemia positivity (PCR assay) | 36 (100%) |
| End-organ disease (according to published criteria) | 4 (11%) |
| Interstitial pneumonia | 3 |
| Enteritis | 1 |
| Median number of CMV copies at first detection (range)1 | 895 (188-10120) |
| Median day from transplant at first detection (range) | 33 (12-77) |
| Pre-transplant CMV IgG seropositivity | 36 (100%) |
| Outcome | |
| Treatment2 | |
| Ganciclovir | 8 |
| Foscarnet sodium | 16 |
| Valganciclovir | 12 |
| Immunoglobulins | 4 |
| Need of hospital admission | 20 (55%) |
| Hematological recovery, median (range)3 | |
| Neutrophilis > 500/mcL | 14 (10-25) |
| Platelets > 20000/mcL | 20 (11-88) |
| Alive | 33 (92%) |
| Dead (48, 62, 89 d from transplant) | 3 (8%) |
Limit of detection of PCR testing: 88 copies/mL;
Foscarnet sodium dosage: 60 mg/kg twice daily for 14 d, than 60 mg/kg per day for subsequent 5 d weekly for 2 wk); Ganciclovir dosage: 5 mg/kg twice daily for 14 d, than 5 mg/kg per day for subsequent 5 d weekly for 2 wk; Valganciclovir dosage: 900 mg twice daily for 14 d, than 900 mg/d for subsequent 5 d weekly for 2 wk;
The occurrence of a symptomatic CMV reactivation after ASCT, requiring antiviral treatment, leads to a delay in neutrophilis and platelets recovery (P = 0.003 and P = 0.001 respectively). ASCT: Autologous hematopoietic stem cell transplantation; CMV: Cytomegalovirus.