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Viral Infection

Survey of CMV management in pediatric allogeneic HSCT programs, on behalf of the Inborn Errors, Infectious Diseases and Pediatric Diseases Working Parties of EBMT

Bone Marrow Transplantation volume 49, pages 276–279 (2014)Cite this article

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Abstract

Human CMV infection is a frequent complication after HSC in children with remarkable morbidity and mortality. Antiviral drugs are relatively efficient but have numerous side effects. They are used as prophylactic, pre-emptive or therapeutic medicines. It is still a matter of debate which option is the best strategy. No uniform procedure has emerged regarding these three options, and new immunologic tools have raised more questions for physicians. To assess the current practice in the management of CMV infection, we sent a questionnaire to the EBMT centers performing hematopoietic SCT (HSCT) in children. Fifty-six out of 196 responded to the questionnaire (28.5%). Quantitative PCR was the most common monitoring tool (44/56). Only 4/56 centers use the pp65 antigenemia alone. All centers used pre-emptive strategy (56/56). 21/56 centers also used prophylactic measures, 13/21 after analysis of donor/receptor serologic status. Ganciclovir was the most common first-line agent for CMV disease (55/56). The most common dose and duration for induction treatment were 5 mg/kg bid (47/55) for 14 days (20/55). There is no uniform procedure for researching resistance strain, antiviral second-line therapy or cell therapy. A harmonization process should enable sound prospective trials to improve prevention, control and cure of CMV disease in children and adolescents.

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Acknowledgements

We thank all the participating centers: Alger CIC 703 (Algeria), Amman CIC 580 (Jordania), Ankara CIC 617 (Turkey), Antalya CIC 618 (Turkey), Barcelona CIC 422 (Spain), Bordeaux CIC 978 (France), Bratislava CIC 684 (Slovakia), Bruxelles CIC 234 (Belgium), Budapest CIC 824 (Hungria), Christchurch CIC 798 (New Zealand), Copenhagen CIC 206 (Denmark), Cracow CIC 507 (Poland), Dresden CIC 808 (Germany), Dublin CIC 774 (Ireland), Erlangen CIC 809-2 (Germany), Thessaloniki CIC 561 (Greece), Firenze (Italy), Frankfurt CIC 138 (Germany), Genova CIC 274 (Italy), GrazCIC 593 (Austria), Halle CIC 654 (Germany), Hanover CIC 295 (Germany), Helsinki CIC 219 (Finland), Idar-Oberstein CIC 592 (Germany), Kiel CIC 256:2 (Germany), Leeds CIC 254 (UK), Leiden CIC 203 (The Netherlands), Leuven CIC 209 (Belgium), Liverpool CIC 773 (UK), LyonCIC 806 (France), Malaga CIC 576 (Spain), Marseille CIC 192 (France), Milano CIC 813 (Italy), Monza CIC 279-1 (Italy), Moscow CIC 694 (Russia), Munich CIC 513-2 (Germany), Paris CIC 631 (France), Pescara CIC 248 (Italy), Petach-Tikva CIC 755 (Israel), Porto CIC 291 (Portugal), Pragha CIC 452.1 (Czech Republic), Reggio-Calbria CIC 587 (Italy), Riyadh CIC 397 (Saudi Arabia), Roma CIC 232 (Italy), Roma CIC 383(Italy), Rouen CIC 941 (France), Saint-Petersburg CIC 725 (Russia), Stockholm CIC 212 (Sweden), Sydney (Australia), Tartu CIC 742 (Estonia), Torino CIC 305 (Italy), Toulouse (France), Turku CIC 225 (Finland), Verona CIC 623 (Italy), Vienna CIC 528 (Austria), Vilnius CIC 508 (Lituania), Wroclaw CIC 817 (Poland).

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Authors and Affiliations

  1. Department of Hematology and Immunology, Hospital Robert Debre, Paris 7—Paris Diderot University, Paris, France

    T Bontant & J-H Dalle

  2. Department of Pediatric Hematology and Oncology, University Hospital Motol, 2nd Medical School, Charles University, Prague, Czech Republic

    P Sedlaçek

  3. Clinica Pediatrica Università degli Studi di Milano Bicocca, Ospedale San Gerardo, Monza (Milano), Italy

    A Balduzzi

  4. Chair of EBMT Inborn Error Working Party, Molecular Immunology Unit, UCL Institute of Child Health, London, UK

    B Gaspar

  5. Chair of EBMT Infectious Disease Working Party, Paediatric Haematology Oncology Policlinico G.B. Rossi, Verona, Italy

    S Cesaro

  6. Division of Hematology, Department of Internal Medicine II, University Hospital of Würzburg, Würzburg, Germany

    H Einsele

  7. Chair of EBMT Paediatric Diseases Working Party, St Anna Children’s Hospital, Vienna, Austria

    C Peters

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  1. T Bontant
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  2. P Sedlaçek
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Correspondence to J-H Dalle.

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Bontant, T., Sedlaçek, P., Balduzzi, A. et al. Survey of CMV management in pediatric allogeneic HSCT programs, on behalf of the Inborn Errors, Infectious Diseases and Pediatric Diseases Working Parties of EBMT. Bone Marrow Transplant 49, 276–279 (2014). https://doi.org/10.1038/bmt.2013.164

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