Cytomegalovirus Infection Monitoring in Bone Marrow Transplant Recipients from Whole Blood versus Plasma using Real-Time PCR

Abstract

Introduction: Cytomegalovirus (CMV) infection in immuno-compromised bone marrow transplant recipients is known. Its infection is about 90% in Indian population, but its symptoms in various age groups in different blood components are scanty and variable. Aim: To evaluate the Whole Blood (WB) and Plasma (PL) samples in population of adult and paediatric leukaemia bone marrow recipients using real-time PCR for CMV infection monitoring. Materials and Methods: In the present observational study, total of 1021 allogeneic bone marrow transplant recipients from our referral centre, including 90 adults and 171 children (paediatric) with follow-up cases were analysed for viral loads in all cases from March 2017 to December 2018. A suitable RT PCR assigned to amplify the conserved region of the UL132 gene to study with respect to two biological components (WL & PL) was investigated in all the patients. Results: The results for CMV infection analysed on both PL and WB showed a good correlation. The kinetics of CMV DNA viral load within the same patient in both WB and PL showed no significant difference. In 2112 follow-up low level of CMV DNA persisted in WB (4.78%), while it was absent in PL. Conclusion: The use of CMV PCR for WB and PL is appropriate to guide implementation and discontinuation of therapy to CMV might lower the risk of CMV disease when given accurate treatment. It might also assist reduce the side effects and duration of treatment. Detection of residual viremia in WB and PL might also offer comparable results in our study cohort.

Keywords

• immuno-depressant patients
• infection
• polymerase chain reaction