¹Second Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan

²Third Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan

Correspondence to: Dr H Takatsuka, Second Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan

Certain human leukocyte antigens may increase the risk of cytomegalovirus interstitial pneumonitis, an important complication of bone marrow transplantation. The prevalence of this pneumonitis was compared between patients possessing either HLA-B51 or HLA-B52 and patients without either antigen. The role of tumor necrosis factor- in cytomegalovirus interstitial pneumonitis was also studied. Among 72 patients undergoing allogeneic bone marrow transplantation at our institution during the past 5 years, HLA-B51 or -B52 was detected in 29. Among these 29 patients, 13 (45%) developed cytomegalovirus interstitial pneumonitis, a significantly higher rate (P < 0.001) than among patients without these hla types (4/43, 9%). in the pre-conditioning and stable phases, tumor necrosis factor- levels were higher in patients with hla-b51 or hla-b52 than in patients without (P < 0.05; t-test). Throughout the period from pre-conditioning to around day 40, except on day 0, tumor necrosis factor- levels were also significantly higher (P < 0.05 to P < 0.001) in patients developing cytomegalovirus infection than in those without it. these results suggest that hla-b51 and hla-b52 may be risk factors for cytomegalovirus interstitial pneumonitis after bone marrow transplantation, with an increase of tumor necrosis factor- also being involved. Bone Marrow Transplantation (2000) 25, 861-865.

cytomegalovirus interstitial pneumonitis; human leukocyte antigen; bone marrow transplantation; tumor necrosis factor-