Detection and Monitoring of Cytomegalovirus(CMV) in Bone Marrow Transplant(BMT) Recipients by Real-Time PCR.

Cytomegalovirus(CMV) is an important pathogen in persons undergoing bone marrow and solid organ transplantation. Based on sero-epidemiological studies, the sero-prevalence varies between 30 to 100 % in different countries.Only 20-25 % of patients develop CMV disease. We could detect CMV DNA in this patients by Real-Time PCR(RT-PCR) For monitoring of CMV reaction. If copy number of CMV was increased, preemptive thrapy will be start. 51 recipients of BMT (9-51 years) were monitored as weekly intervals until day 100 after transplantation.For amplification of the pp65 gene (UL83) RT-PCR assay and pp65 Antigenemia method were preformed in parallel with 415 samples.By cloning of this region, we made standards for RT-PCR.The results obtained by the two techniques were significantly correlated (p<0.01). We could detected 13×101-15×107copies/2×105cells by RT-PCR.76% of patients developed more than one episode of CMV replication. First positive result of RT-PCR 13 days earlier than first positive of pp65 Antigenemia. After preemptive thrapy 16 days (7-21 days) needed to become negative result of RT-PCR. There was no relationship between death and increase of CMV copy(p<0.419). RT-PCR was more sensitive than pp65 Antigenemia. After preemptive thrapy, negative results of RT-PCR were the best indicator for determining of successful treatment. Reaction of CMV in our patients mostly endogenus and depend on kind of immunosuppressive thrapy. If copy number of CMV increased one log, CMV reaction developed 1.22 fold.

Cytomegalovirus(CMV), Bone Marrow Transplant(BMT), Real-Time PCR(RT-PCR), preemptive thrapy