CMV after hematopoietic stem cell transplantation
From IDWiki
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 |
