Cytomegalovirus in Allogeneic Hematopoietic Transplantation: Impact on Costs and Clinical Outcomes Utilizing a Preemptive Strategy

Abstract Background Cytomegalovirus (CMV) results in significant morbidity and mortality following hematopoietic cell transplantation (HCT). Establishing the cost and clinical impact are imperative to selecting appropriate CMV preventative strategies. Methods This is a retrospective cohort study of consecutive patients undergoing their first allogeneic HCT between January 1, 2009 and December 31, 2013. Detailed clinical and institutional cost data were obtained from the start of conditioning through one-year post-transplant. Baseline characteristics, resource utilization, costs and outcomes were compared between patients with and without clinically significant CMV infection (csCMVi). Results One-hundred seventy out of 388 (44%) patients developed csCMVi within one-year following HCT. Within the first post-transplant year, patients with csCMVi had significantly longer transplant lengths of stay (mean 91.7 vs. 78.3 days, p Conclusions Allogeneic HCT patients with csCMVi had significantly greater medical resource utilization and costs than those without. However, clinical outcomes including GVHD, infections and mortality were similar in both groups. Future study is needed to determine the cost effectiveness of CMV preventative modalities.