Cytomegalovirus Viral Load Continues to Predict Poor Outcomes in Adults and Children Despite Improved Hematopoietic Cell Transplantation Success

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CMV viral load is a significant predictor of CMV disease, overall mortality, and nonrelapse mortality in HCT recipients.
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76% of patients experienced CMV reactivation by day 100 post-HCT, with lower incidence in pediatric patients.
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The strongest correlation between CMV viral load and mortality was found in patients with viral load >3 log10 and lymphocyte count <300 cells/μL.
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Recent improvements in transplantation techniques have diminished the association of CMV viral load with overall and nonrelapse mortality.
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This study emphasizes the need for accurate accounting of confounders when assessing the impact of CMV viral load on clinical outcomes.

Open Forum Infectious Diseases

by Alicja Sadowska-Klasa, Hu Xie, Danniel Zamora, Alpana Waghmare, Joshua A Hill, Elizabeth R Duke, Margaret L Green, Masumi Ueda Oshima, Brenda M Sandmaier, Keith R Jerome, Wendy M Leisenring, Michael Boeckh
September 26, 2025

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