Limited predictive value of real-time quantitative PCR cytomegalovirus monitoring in the blood. Fatal CMV pneumonia in an autologous stem cell transplant recipient previously treated with alemtuzumab.
Kazimierz Halaburda, Barbara Nasilowska-Adamska, Piotr Grabarczyk, Andrzej Szczepinski, Tomasz Szpila, Krzysztof Warzocha, Bozena Marianska
Ann Transplant 2007; 12(2): 37-40
Available online: 2007-06-11
Background: Patients treated with alemtuzumab are at very high risk for cytomegalovirus (CMV) reactivation. Also, in those who develop reactivation short time before stem cell transplantation the risk of fatal complications is extremely high.
Case Report: We describe a 21-year-old patient with anaplastic large T-cell lymphoma who developed CMV reactivation after alemtuzumab treatment and received high-dose chemotherapy with autologous stem cell transplantation for progressive disease and severe bone marrow aplasia. Blood samples of the patient were tested regularly for CMV reactivation with real-time quantitative PCR. Even though it is considered the most sensitive available method it did not allow us to predict in advance development of fatal CMV pneumonia in this patient.
Conclusions: The case report illustrates limitations of prognostic value of quantitative real-time PCR CMV assessment in blood samples.
Keywords: cytomegalovirus pneumonia, alemtuzumab, autologous stem cell transplantation, real-time PCR