1. ¹Charité Campus Virchow Klinikum, Humboldt-Universität zu Berlin, Medizinische Klinik m.S. Hämatologie und Onkologie, Berlin, Germany
2. ²Charité Campus Mitte, Humboldt-Universität zu Berlin, Medizinische Klinik II m.S. Onkologie und Hämatologie, Berlin, Germany
3. ³Charité Campus Buch, Robert-Rössle Klinik, Medizinische Klinik mit Schwerpunkt Onkologie, Hämatologie und Tumorimmunologie, Germany
4. ⁴Robert Koch-Institut, Berlin, Germany

Correspondence: Professor Dr med. W Siegert, Medizinische Klinik II mit Schwerpunkt Onkologie und Hämatologie, Charité-Campus Charité Mitte, Schumannstr. 20-21, 10117 Berlin, Germany

Received 20 December 2002; Accepted 20 March 2003.

Abstract

Since the incidence of cytomegalovirus (CMV) infections after hematopoietic stem cell transplantation (HSCT) may depend on the intensity of the pretreatment, we studied the incidence of CMV infections after reduced-intensity compared to myeloablative conditioning. A total of 82 patients with matched related or unrelated donors were prospectively monitored for CMV infections after HSCT by CMV-PCR techniques, CMV-antigenemia and clinical observation. A total of 45 patients received reduced-intensity conditioning consisting of fludarabine, busulfan and ATG and 37 patients received myeloablative conditioning. Leukocyte engraftment occurred after a median of 15 vs 18 days (P=0.012) and platelet engraftment after 12 days vs 20 days (P=0.001), respectively. Acute graft-versus-host disease (GVHD) grade II–IV was observed in 58 vs 54% patients (P=0.737), respectively. The onset and peak values of CMV-antigenemia and DNAemia and the incidence of CMV infections did not differ statistically significantly between the two treatment groups. Multivariate analysis confirmed CMV seropositivity of the recipient (P=0.035), acute GVHD II–IV (P=0.001) but not the type of conditioning as significant risk factors for CMV-antigenemia. In conclusion, the kinetics of CMV-antigenemia and DNAemia and the incidence of CMV infections were not statistically different in patients who received HSCT after reduced-intensity conditioning with fludarabine, busulfan and ATG compared to myeloablative conditioning.