Cytomegalovirus (CMV) DNA Quantitation in Bronchoalveolar Lavage Fluid from Hematopoietic Stem Cell Transplant Recipients with CMV Pneumonia

Abstract

Background. Quantitative cytomegalovirus (CMV) DNA-specific polymerase chain reaction (PCR) analysis is widely used as a surveillance method for hematopoietic stem cell transplant (HCT) recipients. However, no CMV DNA threshold exists in bronchoalveolar lavage (BAL) to differentiate pneumonia from pulmonary shedding. Methods. We tested archived BAL fluid samples from 132 HCT recipients with CMV pneumonia and 139 controls (100 patients with non-CMV pneumonia, 18 with idiopathic pneumonia syndrome [IPS], and 21 who were asymptomatic) by quantitative CMV and β-globin DNA-specific PCR. Results. Patients with CMV pneumonia had higher median viral loads (3.9 log 10 IU/mL; interquartile range [IQR], 2.6-6.0 log 10 IU/mL) than controls (0 log 10 IU/mL [IQR, 0-1.6 log 10 IU/mL] for patients with non-CMV pneumonia, 0 log 10 IU/mL [IQR, 0-1.6 log 10 IU/mL] for patients with IPS, and 1.63 log 10 IU/mL [IQR, 0-2.5 log 10 IU/mL] for patients who were asymptomatic; P