A. HUMAR, P. ST. LOUIS, T. MAZZULLI, A. MCGEER, J, LIPTON, H. MESSNER, K. S. MACDONALD. Department of Microbiology and Medicine, Mount Sinai Hospital, Department of Hematology and Oncology, Princess Margaret Hospital, U. of Toronto, Toronto, Ontario.

Objective: To assess the relationship between serum cytokines and cytomegalovirus (CMV) reactivation following allogenic bone marrow transplantation (BMT)

Methods: We performed weekly measurements of IL-6, IL-8, and TNF-a, CMV antigenemia, CMV blood cultures, and a day 35 CMV surveillance bronchoscopy in 75 allogeneic BMT patients.

Results: 44/75 (58.7%) patients developed CMV infection and 19/75 (25.3%) developed clinical CMV disease. The mean maximum level of IL-6 was 187.6 ± 40.4 pg/ml in patients who developed CMV infection compared to 79.0 ± 20.1 pg/ml in patients without infection (p=0.013). Levels of IL-8 (179.8 ± 42.7 vs. 96.5 ± 38.4 pg/ml; p=0.027) and TNF –a (10.6 ± 1.2 vs. 7.3 ± 0.9 pg/ml; p=0,054) were also increased in patients with CMV infection. Maximum levels of IL-6 were significantly higher in patients with active CMV disease compared to those who did not develop CMV disease (281.2 ± 85.5 vs. 95.7 ± 15.0 pg/ml, p=0.034). Levels of IL-8 and TNF-a were also elevated in patients with CMV disease, but to a lesser degree. In a logistic regression model including other risk factors for CMV, increased IL-6 levels were independently predictive of CMV disease (OR=1.77 per 100 pg/ml increase in IL-6; p=0.004). Cytokine elevations temporally preceded CMV disease in several patients although maximum levels were often observed with the onset of clinical disease.

Conclusion: Cytokines may play an important role in the pathogenesis of CMV post BMT and may be useful as a screening predictor for CMV infection or disease.

Presented at:

CANADIAN ASSOCIATION FOR CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES (CACMID), 66^th Conjoint Meeting on Infectious Diseases, Toronto, ON, Canada, Nov 8-12, 1998.