CMV after hematopoietic stem cell transplantation: Difference between revisions

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Revision as of 21:05, 6 March 2020

Management

  • Most frequently managed with weekly viral loads and preemptive treatment (PET) at a lab-specific threshold
  • Treatment is typically with valganciclovir 900 mg po daily, but may need ganciclovir 5 mg/kg IV if no oral access, or foscarnet 90 mg/kg IV q12h followed by q24h if resistance is suspected
  • Use CMV safe (leukoreduced or filtered) blood products if the recipient is CMV seronegative
Serostatus Blood products Duration of PET
D-/R- CMV safe weeks 2 to 12
D+/R- CMV safe weeks 2 to 12
autologous R- CMV safe weeks 2 to 5
D±/R+ CMV untested weeks 2 to 12, then q2-4wk until week 26
autologous R+ CMV untested weeks 2 to 5