Survey of CMV management in pediatric allogeneic HSCT programs, onbehalf of the Inborn Errors, Infectious Diseases and Pediatric Diseases Working Parties of EBMT. Bone Marrow Transplant.

Human CMV infection is a frequent complication after HSC in children withremarkable morbidity and mortality. Antiviral drugs are relatively efficient but have numerous side effects. They are used as prophylactic, pre-emptive or therapeutic medicines. It is still a matter of debate which option is the beststrategy. No uniform procedure has emerged regarding these three options, and new immunologic tools have raised more questions for physicians. To assess thecurrent practice in the management of CMV infection, we sent a questionnaire to the EBMT centers performing hematopoietic SCT (HSCT) in children. Fifty-six outof 196 responded to the questionnaire (28.5%). Quantitative PCR was the most common monitoring tool (44/56). Only 4/56 centers use the pp65 antigenemia alone.All centers used pre-emptive strategy (56/56). 21/56 centers also usedprophylactic measures, 13/21 after analysis of donor/receptor serologic status.Ganciclovir was the most common first-line agent for CMV disease (55/56). Themost common dose and duration for induction treatment were 5 mg/kg bid (47/55) for 14 days (20/55). There is no uniform procedure for researching resistancestrain, antiviral second-line therapy or cell therapy. A harmonization processshould enable sound prospective trials to improve prevention, control and cure of CMV disease in children and adolescents