[Cytomegalovirus enteritis in recipients of allogeneic peripheral blood stem cell transplantation].

OBJECTIVE

To report 6 cases of cytomeganlovirus (CMV) enteritis in allogeneic bone marrow transplantation (allo-BMT) or peripheral blood stem cell transplantation(PBSCT) recipients and the outcome after treatment.

METHODS

The 6 patients suffered from leukemia and received allo-BMT or allo-PBSCT.

RESULTS

Five of the 6 patients had acute GVHD II-III at 42, 26, 66, 45 and 57 days after transplantation respectively and they recovered after proper treatment. However they soon had severe diarrhea, abdominal pain or/and gastrointestinal bleeding, 5 of the 6 patients received endoscopic examination with biopsy at 50, 57, 80, 65, 35 days after transplantation respectively. They were all diagnosed as having CMV enteritis based on the presence of cytomegalic cells on mucosal biopsy specimens stained with hematoxylin and eosin. Meanwhile the immunoperoxidase stain of histologic specimens for CMV antigen or in situ hybridization by CMV DNA probe was positive. One patient was diagnosed CMV enteritis at 138 days after transplantation based on the clinic and response to therapy. They received antiviral treatment with ganciclovir (DHPG) 500 mg/d for 4 to 21 days, foscarnet 2.4 g q8 h or 4.8 g q12 h for 21 to 90 days, garlic extract 60-120 mg/d, globulin and other supportive measures. All the 6 cases had complete clinical response.

CONCLUSIONS

CMV enteritis should be diagnosed as soon as possible with histopathologic examination and early proper treatment may lead to good clinical response.