Monitoring and management of CMV and EBV after autologous haematopoietic stem cell transplantation for autoimmune diseases: a survey of the EBMT Autoimmune Diseases Working party (ADWP)

Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections and diseases are infrequent but considerable complications among autologous haematopoietic stem cell transplantation (HCT) recipients [ 1 , 2 ]. Guidelines have been developed for the disease monitoring and management in haematologic indications [ 3 , 4 ], and have also featured in specific guidelines for autoimmune diseases [ 5 ]. However, adherence to recommendations may vary, as shown by the results of a recent survey conducted by the Infectious Diseases Working Party (IDWP) of the European Society for Blood and Marrow Transplantation (EBMT) on the management of CMV infection after allogeneic HCT [ 6 ]. Given the increasing activity in autologous HCT for autoimmune diseases (ADs) [ 7 ], there is a need to understand transplant centre policy for monitoring and management of CMV and EBV reactivations. In this context, the use of serotherapy as part of the conditioning regimen, commonly anti-thymocyte globulin, may represent a risk factor for viral infections after autologous HCT [ 8 ]. We therefore undertook a survey to investigate the real world of EBMT practice in centres performing autologous HCT for ADs.