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Prevalence and patterns of cytomegalovirus DNAemia in adult patients with acute lymphoblastic leukemia on chemotherapy
S. Gulia, U. Dangi, S. Biswas, R. Kelkar, H. Menon, M. Sengar Abstract
Th e use of immunosuppressive agents such as high-dose steroids and anti-metabolites for prolonged periods can predispose patients with acute lymphoblastic leukemia (ALL) to develop cytomegalovirus (CMV) reactivation and disease, more so in countries with a background of high CMV seropositivity ( 90%) such as India [1]. Th ere are abundant data on the pattern and time course of CMV reactivation or primary infection in allogeneic stem cell transplant recipients, and well-defi ned strategies have been developed for prophylaxis, screening and pre-emptive treatment [2]. However, there is a remarkable paucity of data regarding CMV reactivation in ALL. Reactivation can lead to prolonged cytopenias, fever and other manifestations, which are often misdiagnosed and treated empirically with antimicrobials. Delays in diagnosis and therapy can compromise the dose intensity of chemotherapy, a key to achieving cure in ALL.
