Summary
Cytomegalovirus (CMV) infection occurs in approximately 50% of all marrow transplant recipients, but is more common in CMV-seropositive patients than CMV-seronegative patients. Sources of infection include reactivation of latent endogenous virus, blood products from CMV-seropositive blood donors, and bone marrow from a CMV-seropositive donor. The most common and severe clinical syndrome associated with CMV infection is interstitial pneumonia, which occurs in about 15% of all allotransplants but is less frequent in syngeneic and autologous transplants. Risk factors for CMV pneumonia include CMV-seropositivity before transplant, older age, conditioning with total-body irradiation, and severe graft-versus-host disease (GVHD). The rapid diagnosis of CMV pneumonia has been facilitated by using CMV monoclonal antibodies in either immunochemical stains or centrifugation cell cultures of bronchoalveolar lavage fluid. Treatment of CMV pneumonia remains problematic, but therapy with a combination of intravenous immune globulin (IVIG) plus ganciclovir has resulted in the best survival rates. In CMV-seronegative patients, CMV infection and pneumonia can be prevented or modified by the use of CMV-seronegative blood products and IVIG. IVIG also reduces other infections and GVHD. For CMV-seropositive patients, effective prophylaxis for CMV reactivation and pneumonia has not yet been established, but trials of prophylactic ganciclovir are being conducted.
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References
Appelbaum FR, Meyers JD, Fefer A, Flournoy N, Cheever MA, Greenberg PD, Hackman R, Thomas ED (1982) Nonbacterial nonfungal pneumonia following marrow transplantation in 100 identical twins. Transplantation 33: 265–268
Apperly JF, Goldman JM (1988) Cytomegalovirus: biology, clinical features and methods for diagnosis. Bone Marrow Transplant 2: 253–264
Araullo-Cruz TP, Ho M, Armstrong JA (1978) Protective effect of early serum from mice after cytomegalovirus infection. Infect Immun 21: 840–842
Aulitzky WE, Tilg H, Niederweiser D, Hack M, Meister B, Huber C (1988) Human monoclonal antibodies neutralizing cytomegalovirus (CMV) for prophylaxis of CMV disease: report of a phase 1 trial in bone marrow transplant recipients. J Infect Dis 158: 488–489
Beschorner WE, Hutchins GM, Burns WH, Saral R, Tutschka P, Santos GW (1980) Cytomegalovirus pneumonia in bone marrow transplant recipients: miliary and diffuse patterns. Am Rev Respir Dis 122: 107–114
Bortin MM, Rimm AA (1989) Increasing utilization of bone marrow transplantation. II. Results of the 1985–1987 survey. Transplantation 48: 453–458
Bowden RA, Meyers JD (1990) Prophylaxis of cytomegalovirus infection. Semin Hematol 27 Suppl 1: 17–21
Bowden RA, Sayers M, Flournoy N, Newton B, Banaji M, Thomas ED, Meyers JD (1986) Cytomegalovirus immune globulin and seronegative blood products to prevent primary cytomegalovirus infection after marrow transplantation. N Engl J Med 314: 1006–1010
Bowden RA, Sayers M, Gleaves CA, Banaji B, Newton B, Meyers JD (1987) Cytomegalovirus-seronegative blood components for the prevention of primary cytomegalovirus infection after marrow transplantation. Considerations for blood banks. Transfusion 27: 478–481
Bowden RA, Day LM, Amos DE, Meyers JD (1987) Natural cytotoxic activity against cytomegalovirus-infected target cells following marrow transplantation. Transplantation 44: 504–507
Bowden RA, Dobbs S, Kopecky KJ, Crawford S, Meyers JD (1988) Increased cytotoxicity against cytomegalovirus-infected target cells by bronchoalveolar lavage cells from bone marrow transplant recipients with cytomegalovirus pneumonia. J Infect Dis 158: 773–779
Bratanow NC, Ash RC, Turner PA, Smith R, Haasler G, Chitambar C, Hansen R, Casper J (1987) Successful treatment of serious cytomegalovirus (CMV) disease with 9(1,3-dihydroxy-2-propoxymethyl)guanine(ganciclovir, DHPG) and intravenious immunoglobulin (IVIG) in bone marrow transplant (BMT) patients (Abstract no 254). Exp Hematol 15: 541
Bryson YJ, Jorgan MC, Winston DJ, Coloma L, Gale RP (1980) Prospective study of viral infections and interstitial pneumonia in bone marrow transplant recipients ( Abstr ). Clin Res 28: 111
Chou S (1987) Cytomegalovirus infection and reinfection transmitted by heart transplantation. J Infect Dis 155: 1054–1066
Cordonnier C, Escudier E, Nicolas JC, Fleury J, Deforges L, Ingrand D, Bircout F, Bernandin JF (1987) Evaluation of three assays on alveolar lavage fluid in the diagnosis of cytomegalovirus pneumonitis after bone marrow transplantation. J Infect Dis 155: 495–500
Crawford SW, Bowde RA, Hackman RC, Gleaves CA, Meyers JD, Clark JG (1988) Rapid detection of cytomegalovirus pulmonary infection by bronchoalveolar lavage and centrifugation culture. Ann Intern Med 108: 180–185
Dankner WM, McCutchan JA, Richman DD, Hirata K, Spector SA (1990) Localization of human cytomegalovirus in peripheral blood leukocytes by in situ hybridization. J Infect Dis 161: 31–36
Dowling JN, Wu BC, Armstrong JA, Ho M (1977) Enhancement of murine cytomegalovirus infection during graft-versus-host reaction. J Infect Dis 135: 990–994
Emanuel D, Peppard J, Stover D, Gold J, Armstrong D, Hammerling V (1986) Rapid immunodiagnosis of cytomegalovirus pneumonia by bronchoalveolar lavage using human and murine monoclonal antibodies. Ann Intern Med 104: 476–481
Emanuel D, Cunningham I, Jules-Elysee K, Brochstein JA, Kerman NA, Laver J, Stover D, White DA, Fels A, Polsky B, Castro-Malaspina H, Peppard JR, Bartus P, Hammerling U, O’Reilly RJ (1988) Cytomegalovirus pneumonia after bone marrow transplantation successfully treated with the combination of ganciclovir and high-dose intravenous immune globulin. Ann Intern Med 109: 777–782
Erice A, Jordan MC, Chace BA, Fletcher C, Chinnock BJ, Balfour HH (1987) Ganciclovir treatment of cytomegalovirus disease in transplant recipients and other immunocompromised hosts. JAMA 257: 3082–3087
Gleaves CA, Smith TF, Shuster EA, Pearson GR (1985) Comparison of standard tube and shell vial cell culture techniques for the detection of cytomegalovirus in clinical specimens. J Clin Microbiol 21: 217–221
Gleaves CA, Reed EC, Hackman RC, Meyers JD (1987) Rapid diagnosis of invasive cytomegalovirus infection by examination of tissue specimens in centrifugation culture. Am J Clin Pathol 88: 354–358
Gleaves CA, Myerson D, Bowden RA, Hackman RC, Meyers JD (1988) Direct detection of cytomegalovirus from bronchoalveolar lavage using a rapid in situ DNA hybridization assay compared to centrifugation culture (abstr no 808). In: 28th Inter-science Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, p 252
Graham-Pole J, Camitta B, Gross S, Herzig R, Koch P, Mahoney D, Casper J, Elfenbein G, Marcus R, Munoz L, Pick T, Spruce W, Steuber P, Weiner R (1988) Intravenous immunoglobulin may lessen all forms of injection in patients receiving allogeneic bone marrow transplantation for acute lymphoblastic leukemia: a Pediatric Oncology Group study. Bone Marrow Transplant 3: 559–566
Griffiths PD, Stirk PR, Blacklock HA, Milburn HJ, DuBois RM, Prentice HG (1987) Rapid diagnosis and treatment of cytomegalovirus pneumonitis. In: Gale RP, Champlin RE (eds) Progress in bone marrow transplantation. Liss, New York, pp 583–587
Grob JP, Grundy JE, Prentice HG, Griffiths PD, Hoffbrand AV, Hughes MD, Tate T, Wimperis JZ, Brenner MK (1987) Immune donors can protect marrow-transplant recipients from severe cytomegalovirus infections. Lancet 1: 774–776
Grundly JE, Super M, Griffiths PD (1986) Reinfection of seropositive allograft recipient by cytomegalovirus from donor kidney. Lancet 1: 159–160
Grundy JE, Shanley JD, Griffiths PD (1987) Is cytomegalovirus interstitial pneumonitis in transplant recipients an immunopathological condition? Lancet 2: 996–998
Hersman J, Meyers JD, Thomas ED, Buckner CD, Clift R (1982) The effect of granulocyte transfusions on the incidence of CMV infection after allogeneic marrow transplantation. Ann Intern Med 96: 149–152
Hsia K, Spector DH, Lawrie J, Spector SA (1989) Enzymatic amplification of human cytomegalovirus sequences by polymerase chain reaction. J Clin Microbiol 27:1802–1809
Jordan MC, Shanley JD, Stevens JG (1977) Immunosuppression reactivates and disseminates latent murine cytomegalovirus. J Gen Virol 37: 419–423
Kubanek B, Ernst P, Ostendorf P, Schaften U, Wolf PH (1985) Preliminary data of a controlled trial of intravenous hyperimmune globulin in the prevention of cytomegalovirus in bone marrow recipients. Transplant Proc 17: 468–469
Mayo DR, Armstrong JA, Ho M (1977) Reactivation of murine cytomegalovirus by cyclophosphamide. Nature 267: 721–723
McDonald GB, Sharma P, Hackman RC, Meyers JD, Thomas ED (1985) Esophageal infections in immunosuppressed patients after marrow transplantation. Gastroenterology 88: 1111–1117
Meyers JD (1985) Infection in bone marrow transplantation. In: Remington JS, Swartz MN (eds) Current clinical topics in infectious diseases. McGraw-Hill, New York, pp 261–292
Meyers JD (1989) Prevention of cytomegalovirus infection after marrow transplantation. Rev Infect Dis 11[Suppl71: S1691–51705
Meyers JD, Flournoy N, Thomas ED (1980) Cytomegalovirus infection and specific cell-mediated immunity after marrow transplant. J Infect Dis 142: 816–824
Meyers JD, Flournoy N, Thomas ED (1982) Nonbacterial pneumonia after allogeneic marrow transplantation: a review of 10 years’ experience. Rev Infect Dis 4: 1119–1132
Meyers JD, Flournoy N, Wade JC, Hackman RC, McDougall JK, Neiman PE, Thomas ED (1983) Biology of interstitial pneumonia after marrow tranplantation. In: Gale RP, Champlin RE (eds) Progress in bone marrow transplantation. Liss, New York pp 405–423
Meyers JD, Leszcynski J, Zaia JA, Flournoy N, Newton B, Syndman DR, Wright GG, Levin MJ, Thomas ED (1983) Prevention of cytomegalovirus infection by cytomegalovirus immuneglobulin after marrow transplantation. Ann Intern Med 98: 442–446
Meyers JD, Flournoy N, Thomas ED (1986) Risk factors for CMV infection after human marrow transplantation. J Infect Dis 153: 478–488
Meyers JD, Reed EC, Shepp DH, Thornquist M, Dandliker PS, Vicary CA, Flournoy N, Kirk LE, Kersey JH, Thomas ED, Balfour HH (1988) Acyclovir for prevention of cytomegalovirus infection and disease after allogeneic marrow transplantation. N Engl J Med 318: 70–75
Meyers JD, Ljungman P, Fisher LD (1990) Cytomegalovirus excretion as a predictor of cytomegalovirus disease after marrow transplantation: importance of cytomegalovirus viremia. J Infect Dis 162: 373–380
Miller W, Flynn P, McCullough J, Balfour HH, Goldman A, Haake R, McGlave P, Ramsey N, Kersey J (1986) Cytomegalovirus infection after bone marrow transplantation: an association with acute graft-versus-host disease. Blood 67: 1162–1167
Miller W, McCullough J, Balfour HH, Haake R, Ramsey NKC, Goldman A, Bowman R, Kersey J (1988) Prevention of CMV infection by blood products: a randomized trial. J Cell Biochem 12 [Suppl c]: 93
Myerson D, Hackman RC, Nelson JA, Ward DC, McDougall JK (1984) Widespread presence of histologically occult cytomegalovirus. Hum Pathol 15: 430–439
Neiman PE, Reeves W, Ray G, Flournoy N, Lerner KG, Sale GE, Thomas ED (1977) A prospective analysis of interstitial pneumonia and opportunistic viral infection among recipients of allogeneic bone marrow grafts. J Infect Dis 136: 754–767
Reilly RJ, Reich L, Gold J, Kirkpatrick D, Dinsmore R, Kapoor N, Condie R (1983) A randomized trial of intravenous hyperimmune globulin for the prevention of cytomegalovirus (CMV) infections following marrow transplantation: preliminary results. Transplant Proc 15: 1405–1411
Panjwani DD, Ball MG, Berry NJ, Wimperis JZ, Blacklock HA, Prentice HG, Hoff-brand AV, Griffiths PD (1985) Virological and serological diagnosis of cytomegalovirus infection in bone marrow allograft recipients. J Med Virology 16: 357–365
Paulin T, Ringden O, Lönnqvist B, Wahren B, Nilsson B (1986) The importance of pre bone marrow transplantation serology in determining subsequent cytomegalovirus infection. An analysis of risk factors. Scand J Infect Dis 18: 199–209
Pecego R, Hill R, Appelbaum FR, Amos D, Buckner CD, Fefer A, Thomas ED (1986) Interstitial pneumonitis following autologous bone marrow transplantation. Transplantation 42: 515–517
Petersen FB, Bowden RA, Thornquist M, Meyers JD, Buckner CD, Counts GW, Nelson N, Newton BA, Sullivan KM, McIver J, Thomas E (1987) The effect of prophylactic intravenous immune globulin on the incidence of septicemia in marrow transplant recipients. Bone Marrow Transplant 2: 141–148
Quinnan G, Kirmani N, Rook AH, Manischewitz JF, Jackson L, Moreschi G, Santos GW, Saral R, Burns WH (1982) Cytotoxic t cells in cytomegalovirus infection: HLA-restricted T-lymphocyte and non-T-lymphocyte cytotoxic responses correlate with recovery from cytomegalovirus infection in bone marrow transplant recipients. N Engl J Med 307: 7–13
Reed EC, Dandliker PS, Meyers JD (1986) Treatment of cytomegalovirus pneumonia with 9-[2-hydroxy-1-(hydroxymethyl)ethoxymethyl]guanine and high-dose corticosteroids. Ann Intern Med 103: 214–215
Reed EC, Bowden RA, Dandliker PS, Gleaves CA, Meyers JD (1987) Efficacy of cytomegalovirus immunoglobulin in marrow transplant recipients with cytomegalovirus pneumonia. J Infect Dis 156: 641–645
Reed EC, Bowden RA, Dandliker PS, Lilleby KE, Meyers JD (1988) Treatment of cytomegalovirus pneumonia with ganciclovir and intravenous cytomegalovirus immunoglobulin in patients with bone marrow transplants. Ann Intern Med 109: 783–788
Reed EC, Shepp DH, Dandliker PS, Meyers JD (1988) Ganciclovir treatment of CMV infection of the gastrointestinal tract after marrow transplantation. Bone Marrow Transplant 3: 199–206
Reed EC, Wolford JL, Kopecky KL, Lilleby KE, Dandliker PS, Todaro JL, McDonald GB, Meyers JD (1990) Ganciclovir for the treatment of cytomegalovirus gastroenteritis in bone marrow transplant patients. A randomized, placebo-controlled trial. Ann Intern Med 112: 505–510
Reusser P, Schoch HG, Fisher L, Thomas ED, Buckner CD, Meyers JD (1988) Cytomegalovirus (CMV) infection after autologous bone marrow transplantation (ABMT): occurrence of disease and impact on engraftment. Blood 72 Suppl 1: 402
Ringden O, Lönnqvist B, Sundberg B (1987) Cytomegalovirus immune bone marrow donors and interstitial pneumonitis. Lancet 2: 105–106
Ringden O, Pihlstedt P, Volin L, Nikoskelainen J, Lönnqvist B, Ruutu P, Ruutu T, Tuivanen A, Wahren B (1987) Failure to prevent cytomegalovirus infection by cytomegalovirus hyperimmune plasma: a randomized trial by the Nordic BMT group. Bone Marrow Transplant 2: 299–305
Rook AH (1988) Interactions of cytomegalovirus with the human immune system. Rev Infect Dis 10(Suppl 3): S460 - S467
Rubin RH, Wilson EJ, Barrett LV, Medearis DN (1986) The protective effects of hyperimmune anti-murine cytomegalovirus antiserum against lethal viral challenge: the case for passive-active immunization. Clin Immunol Immunopathol 39: 151–158
Ruutu P, Ruutu T, Volin L, Tukiainen P, Ukkonen P, Hovi T (1990) Cytomegalovirus is frequently isolated in bronchoalveolar lavage fluid of bone marrow transplant recipients without pneumonia. Ann Intern Med 112: 913–916
Saxon A, Mitsuyasu R, Stevens R, Champlin RE, Kimata H, Gale RP (1986) Designed transfer of specific immune responses with bone marrow transplantation. J Clin Invest 78: 959–967
Schmidt GM, Kovacs A, Zaia JA, Horak DA, Blume KG, Nademanee AP, O’Donnell MR, Synder DS, Forman SJ (1988) Ganciclovir/immunoglobulin combination therapy for the treatment of human cytomegalovirus-associated interstitial pneumonia in bone marrow allograft patients. Transplantation 46: 905–907
Schmidt GM, Zaia J, Horak D, Kovacs A, Hawkins G, Nademanee A, O’Donnell MR, Synder DS, Stein AS, Paarker PM, Hill R, Blume KG, Forman SJ (1988) Human cytomegalovirus (HCMV) detection in routine bronchoalveolar lavage (BAL) specimen as a predictor for interstitial pneumonia (IP) in allogeneic bone marrow transplantation (BMT) recipients. Blood 72 Suppl 1: 405
Shanley JD (1987) Murine cytomegalovirus pneumonitis in T-cell deficient nude mice (Abstr). 12th Herpes Virus Workshop, Philadelphia
Shanley JD, Pesanti EL (1985) The relation of viral replication to interstitial pneumonitis in murine cytomegalovirus lung infection. J Infect Dis 151: 454–458
Shanley JD, Jordan MC, Stevens JG (1981) Modification by adoptive humoral immunity of murine cytomegalovirus infection. J Infect Dis 143: 231–237
Shanley JD, Pesanti EL, Nugent KM (1982) The pathogenesis of pneumonitis due to murine cytomegalovirus. J Infect Dis 146: 388–396
Shanley JD, Via CS, Sharrow SO, Shearer GM (1987) Interstitial pneumonitis during murine cytomegalovirus infection and graft-versus-host reaction. Characterization of bronchoalveolar lavage cells. Transplantation 44: 658–662
Shepp DH, Dandliker PS, DeMiranda P, Burnette TC, Cederberg DM, Kirk LE, Meyers JD (1986) Activity of 9-[2-Hydroxy-1(hydroxymethyl)ethoxymethyl]guanine in the treatment of cytomegalovirus pneumonia. Ann Intern Med 103: 368–373
Spector SA, Rua JA, Spector DH, McMillan R (1984) Detection of human cytomegalovirus in clinical specimens by DNA—DNA hybridization. J Infect Dis 150:121–126
Spencer GD, Hackman RC, McDonald GB, Amos DE, Cunningham BA, Meyers JD, Thomas ED (1986) A prospective study of unexplained nausea and vomiting after marrow transplantation. Transplantation 42: 602–607
Springmeyer SC, Silvestri RC, Sale GE, Peterson DC, Weems CE, Huseby JS, Hudson LD, Thomas ED (1982) The role of transbronchial biopsy for the diagnosis of diffuse pneumonias in immunocompromised marrow transplant recipients. Am Rev Respir Dis 126: 763–765
Starr SE, Allison AC (1977) Role of T lymphocytes in recovery from murine cytomegalovirus infection. Infect Immun 17: 458–462
Sullivan KM, Kopecky K, Jocom J, Buckner CD, Counts G, Meyers JD, Witherspoon RP, Storb R, Thomas ED (1988) Antimicrobial and immunomodulatory effects of intravenous immunoglobulin in bone marrow transplantation. In: 28th Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology. Washington, p 216
Sullivan KM, Kopecky K, Meyers J, Buckner CD (1990) Immunoglobulin prophylaxis in marrow transplantation. 6th International Symposium on Infections in the Immunocompromised Host, Peebles
Syndman DR, Werner BG, Heinze-Lacey B, Berandi VP, Tilney NL, Kirkman RL, Milford EL, Cho SI, Bush HL, Levey AS, Strom TB (1987) Use of cytomegalovirus immune globulin to prevent cytomegalovirus disease in renal transplant recipients. N Engl J Med 317: 1049–1054
Thomas ED, Storb R, Clift A, Fefer A, Johnson FL, Lerner KG, Glucksberg H, Buckner CD (1975) Bone marrow transplantation. N Engl J Med 292:832–843, 895–902
Tyms AS, Davis JM, Jeffries DJ, Meyers JD (1984) BWB759U, an analogue of acyclovir, inhibits human cytomegalovirus in vitro. Lancet 2: 924–925
Valteau P, Hartmann O, Benhamon E, Callaud JM, Brugieres L, Beaujeau F, Patte C, Flamant P, Lemerle J (1988) Nonbacterial nonfungal interstitial pneumonitis following autologous bone marrow transplantation in children treated with high-dose chemotherapy without total body radiation. Transplantation 45: 737–740
Verdonck LF, DeGast GC, Dekker AW, DeWeger RA, Schuurman Hi, RozenbergArska M (1989) Treatment of cytomegalovirus pneumonia after bone marrow transplantation with cytomegalovirus immunoglobulin combined with ganciclovir. Bone Marrow Transplant 4: 187–189
Weiner RS (1987) Interstitial pneumonia following bone marrow transplantation. In: Gale RP, Champlin RE (eds) Progress in bone marrow transplantation. Liss, New York, pp 507–523
Weiner RS, Bortin MM, Gale RP, Gluckman E, Kay HEM, Kolb HJ, Hartz AJ, Rimm AA (1986) Interstitial pneumonitis after bone marrow transplantation. Ann Intern Med 104: 168–175
Wilson EJ, Medearis DN, Hansen LA, Rubin RH (1987) 9-(1–3-Dihydroxy-2-propoxymethyl)guanine prevents death but not immunity in cytomegalovirus-infected normal and immunosuppressed BALB/c mice. Antimicrob Agents Chemother 31: 1017–1020
Wimperis JZ, Brenner MK, Prentice HG, Reittie JE, Karayiannis P, Griffiths PD, Hoffbrand AV (1986) Transfer of a functioning humoral immune system in transplantation of T-lymphocyte-depleted bone marrow. Lancet 1: 339–343
Wingard JR, Santos GW, Saral R (1985) Late-onset interstitial pneumonia following allogeneic bone marrow transplantation. Transplantation 39: 21–23
Wingard JR, Chen DVH, Burns WH, Fuller DJ, Braine HG, Yeager AM, Kaiser H, Burke PJ, Graham ML, Santos GW, Saral R (1988) Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogeneic bone marrow transplantation. Blood 71: 1432–1437
Wingard JR, Mellits ED, Sostrin MB, Chen DVH, Burns WH, Santos GH, Vriesendorp HM, Beschorner WE, Saral R (1988) Interstitial pneumonitis after allogeneic bone marrow transplantation. Nine-year experience at a single institution. Medicine (Baltimore) 67: 175–186
Wingard JR, Sostrin MB, Vriesendorp HM, Mellits ED, Santos GW, Fuller DJ, Braine HG, Yeager AM, Burns WH, Saral R (1988) Interstitial pneumonitis following autologous bone marrow transplantation. Transplantation 46: 61–65
Winston DJ, Gale RP, Meyers DV, Young LS, UCLA Bone Marrow Transplant Group (1979) Infectious complications of human bone marrow transplantation. Medicine (Baltimore) 58: 1–31
Winston DJ, Ho WG, Howell CL, Miller MJ, Mickey R, Martin WJ, Lin CH, Gale RP (1980) Cytomegalovirus infections associated with leukocyte transfusions. Ann Intern Med 93: 671–678
Winston DJ, Territo MC, Ho WG, Miller MJ, Gale RP, Golde DW (1982) Alveolar macrophage dysfunction in human bone marrow transplant recipients. Am J Med 73: 859–866
Winston DJ, Pollard RB, Ho WG, Gallagher JG, Rasmussen LE, Huang SH, Lin CH, Gosset TG, Merigan TC, Gale RP (1982) Cytomegalovirus immune plasma in bone marrow transplant recipients. Ann Intern Med 97: 11–18
Winston DJ, Ho WG, Champlin RE, Gale RP (1984) Infectious complications of bone marrow transplantation. Exp Hematol 12: 205–215
Winston DJ, Huang ES, Miller MJ, Lin CH, Ho WG, Gale RP, Champlin RE (1985) Molecular epidemiology of cytomegalovirus infections associated with bone marrow transplantation. Ann Intern Med 102: 16–20
Winston DJ, Ho WG, Lin CH, Bartoni K, Budinger MD, Gale RP, Champlin RE (1987) Intravenous immune globulin for prevention of cytomegalovirus infection and interstitial pneumonia after bone marrow transplantation. Ann Intern Med 106: 12–18
Winston PJ, Ho WG, Gale RP, Champlin RE (1987) Treatment and prevention of interstitial pneumonia after bone marrow transplantation. In: Gale RP, Champlin RE (eds) Progress in bone marrow transplantation. Liss, New York, pp 525–544
Winston DJ, Ho WG, Bartoni K, Holland GN, Mitsuyasu RT, Gale RP, Busuttil RW, Champlin RE (1988) Ganciclovir therapy for cytomegalovirus infection in recipients of bone marrow transplants and other immunosuppressed patients. Rev Infect Dis 10 Suppl 3: S540 - S553
Winston DJ, Ho WG, Champlin RE (1989) Current approaches to management of infections in bone marrow transplants. Eur J Clin Oncol 25 Suppl 2: S25 — S35
Winston DJ, Ho WG, Champlin RE (1989) Use of DHPG (ganciclovir) and intravenous immune globulin in bone marrow transplantation. In: Gale RP, Champlin RE (eds) Bone marrow transplantation: current controversies. Liss, New York, pp 553–561
Winston DJ, Ho WG, Champlin RE (1990) Cytomegaovirus infection and interstitial pneumonia after bone marrow transplantation. In: Champlin RE (ed) Bone marrow transplantation. Kluwer, Norwell, pp 113–128
Winston DJ, Ho WG, Champlin RE (1990) Cytomegalovirus infections after allogeneic bone marrow transplantation. Rev Infect Dis 12 Suppl7: S776–5792
Winston DJ, Ho WG, Champlin RE (1991) Ganciclovir and intravenous immunoglobulin in bone marrow transplants. In: Gale RP, Champlin RE (eds) New strategies in bone marrow transplantation. Wiley-Liss, New York, pp 337–348
Witherspoon RP, Lum LG, Storb R (1984) Immunologic reconstitution after human marrow grafting. Semin Hematol 21: 2–10
Zaia JA, Forman SJ, Gallagher MT, Vanderwal-Urbina E, Blume KG (1984) Prolonged human cytomegalovirus viremia following bone marrow transplantation. Transplantation 37: 315–317
Zaia JA, Forman SJ, Ting YP, Vanderwal-Urbina E, Blume KG (1986) Polypeptide-specific antibody response to human cytomegalovirus after infection in bone marrow transplant recipients. J Infect Dis 153: 780–787
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Winston, D.J. (1993). Cytomegalovirus Infection in Bone Marrow Transplantation. In: Becker, Y., Darai, G., Huang, ES. (eds) Molecular Aspects of Human Cytomegalovirus Diseases. Frontiers of Virology, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84850-6_11
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