Cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation: clinical significance and definitions

Abstract

Cytomegalovirus infection is one of the critical and life-threatening infectious complications in patients after allogeneic hematopoietic stem cell transplantation. The most significant risk factors for the development of cytomegalovirus infection are cytomegalovirus serostatus of the donor and recipient and delayed reconstitution of cytomegalovirus-specific CD4+ and CD8+ T lymphocytes after allogeneic hematopoietic stem cells transplantation.The infection may be asymptomatic or may lead to serious complications such as cytomegalovirus disease, which happens in 10-40% of cases. Cytomegalovirus infection has different impact on patients after hematopoietic stem cell transplantation. For instance, acute and chronic graft versus host disease may also be the risk factors for the development of cytomegalovirus infection. There is also information about the influence of cytomegalovirus infection on a graft failure. We also know that cytomegalovirus replication is associated with lower relapse risk in patients with acute myeloid leukemia and chronic myeloid leukemia.Antiviral prophylaxis and preemptive therapy are good strategies to reduce the risk of the cytomegalovirus infection. Despite this, cytomegalovirus infection is still associated with decreased overall survival and increased non-relapse mortality in recipients of allogeneic stem cells.The aim of this review is to systematize modern concepts used in the management and treatment of cytomegalovirus infections in patients after hematopoietic stem cell transplantation.