Cytomegalovirus antigenemia is observed more frequently following allogeneic peripheral blood stem cell transplantation compared to bone marrow transplantation.

One of the major complications following hematopoietic stem cell transplantation (HSCT) is cytomegalovirus (CMV) infection. In our institution, three methods have been applied routinely for the diagnosis of CMV antigenemia (CMV-Ag): 1. Direct immunofluorescence microscopic (IFM) examination; 2. Flow cytometric (FC) analysis; and 3. Serological investigation. We were able to detect CMV-Ag by FC in 18 out of 75 transplanted cases. In 14 of these, positivity was confirmed by IFM as well. CMV-Ag was detected as positive by FC in samples from peripheral blood (14 cases) and/or bronchoalveolar lavage (BAL) fluid (4 cases). Eighteen patients had been transplanted [peripheral blood stem cell transplantation (PBSCT)/bone marrow transplantation (BMT): 16/2]. CMV-Ag was detected in 34% of PBSCTs and 7% of BMTs (p<0.008). Antigenemia was observed at a median of 4.5 months. In most of the patients, graft-versus-host disease (GVHD) was accompained by CMV-Ag. The ratio of acute GVHD/chronic GVHD was 6/10. Out of 18 CMV-Ag positive patients, 16 also had signs of infection. They were all positive by IFM as well. The two methods of CMV-Ag detection were correlated (r=0.619, p<0.0001). An important finding is the higher frequency of CMV-Ag and GVHD in patients who had received PBSCT.