Cytomegalovirus (CMV) infection influence platelet recovery in bone marrow transplantation patients. Patients with CMV infection, primary, reactivated, or latent, require more platelet unit transfusions, this procedure determines increases the risk of transfusion-related infections. In literature there are many reports regarding CMV implication in bone marrow recovery secondary transplant procedure.
The association with CMV infection and slowly recovery of bone marrow secondary chemotherapy in AML was rarely reported
We report 2 cases with delay in platelet recovery after intensive chemotherapy- consolidation phase of acute myeloid leukaemia patients.
Patients male 46 years and female 55 years were diagnosed with AML 1. Diagnose was put using WHO criteria and was not identified any genetic abnormalities. We started 3+7 regimen with obtaining complete remission status. After bone marrow recovery we started consolidation phase with high doses Cytarabine 2 applications. After second application we observed delay in platelet recovery (more than 1 months). Bone marrow biopsy indicated severe aplasia. Serology for CMV infection was positive for IgG antibodies, PCR for CMV was positive indicated active CMV infection. Patients were referred to infectionist and was started antiviral treatment – Gancyclovir. During treatment patients presented increases of platelet count and absence of platelet unit transfusion, in 1 month patients had G1 trombocytopenia (improving of CTCAE grade from G4 to G1)
The delay in bone marrow recovery after intensive chemotherapy used as treatment of acute myeloid leukemia patient represent a warning to check CMV infection presence. This attitude could avoid complications like infections or/and transfusions related.