CMV Reactivation and its Effect on Graft Function in Post H Stem Cell Transplant (HSCT) Patients

Objective: To evaluate the effect of CMV reactivation on graft function and to better understand the factors contributing to PGF in patients underwent HSCT Prospective was done between Jan 2022 to Oct 2022 at the Armed Forces Bone Marrow Transplant Center Methodology: This cohort included 80 patients of all age groups and both genders, suffering from various benign and malignant hematological conditions. Patients experiencing primary graft failure were excluded. CMV reactivation was monitored during two distinct time frames post-transplantation (initial 100 days and day +100 to day +180). Patients with CMV viral load exceeding 2000 copies/mL received antiviral treatment. Graft function was assessed through clinical history, physical examination, blood counts, lineage-specific donor chimerism analysis, and bone marrow examination. Results: Among the study group, 60% of patients experienced CMV reactivation, and 22.5% of these patients receiving antiviral treatment developed myelosuppression. The CD34 dose had a statistically significant correlation with graft function on Day 30 and Day 60, while TNC dose did not. Platelet counts were significantly correlated with Day 60 graft function. Chimerism analysis did not show significant correlations with CMV reactivation at different time points. The overall survival rate was 91.3%, with the most common cause of death being secondary PGF associated with infections Conclusion: Study underscores the significance of CMV reactivation as a common complication post-HSCT, with implications for graft function. We observed a substantial myelosuppressive effect associated with antiviral treatment. The study highlights the importance of CD34 dose and platelet counts in graft function assessment. While further research is needed, our findings emphasize the need for vigilant monitoring and tailored interventions to improve outcomes in post-HSCT patients