Immune reconstitution complicated by CMV retinitis in a pediatric patient who underwent haploidentical CD34+-selected hematopoietic stem cell transplant for acute lymphoblastic leukemia.

Abstract:

:We describe two episodes of CMV retinitis in a pediatric patient who underwent a CD34+ selected graft from his haploidentical father. Both recipient and donor were cytomegalovirus (CMV) seropositive. Both episodes occurred late post-grafting during a phase of complete immunological recovery with sufficient numbers of circulating CMV-specific clones. Antiviral treatment with foscarnet and ganciclovir was successful but prolonged treatment was required to prevent relapses. We hypothesize that this complication was more related to an immune reconstitution process than to an immune-deficient state post-grafting. We conclude that CMV retinitis is a late complication of HSCT that can occur despite satisfactory immune reconstitution. Usually, it is responsive to antiviral therapy. Dilated fundoscopic examination is essential both for examining patients with reduced visual acuity and for screening asymptomatic patients.

journal_name

Int J Hematol

authors

Cesaro S,Boaro MP,Pillon M,Calore E,Cermakova I,Perruccio K,Mengoli C,Messina C

doi

10.1007/s12185-008-0126-z

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

145-148

issue

2

eissn

0925-5710

issn

1865-3774

pii

10.1007/s12185-008-0126-z

journal_volume

88

pub_type

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