PMC6328044_01
Clinical course of the patient. Cytomegalovirus (CMV) copy numbers in folds of 105 in gray shown as drawn through line; administration of hyperimmune globulines (IVIG), cyclosporine (CsA), prednisolone, rituximab (depicted by crosses) and antiviral medication (ACV: acyclovir; FOS: foscarnet; GCV: ganciclovir; LMV: letermovir; VACV: valacyclovir) as indicated above, dectection of UL56 wild type (WT) is depicted as empty circle and UL56 C325Y as black circle respectively.
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CMV were routinely monitored once a week by PCR technique using whole-blood (for detailed information about viral copy numbers see figure 1). CMV reactivation with 7 x 104 copies/ml was detected on day +43. The CMV-treatment schedule is given in figure 1. However, CMV copy numbers raised from 1.5-3.5 x 103 copies/ml up to 3.9 x 105 copies/ml (please refer to figure 1, day 88 et seq.) and Except for nephrotoxicity, no clinical side effects of FOS occurred. EBV reactivation was effectively treated with the monoclonal CD20 antibody rituximab throughout four weeks, at a dosage of 375 mg/m2 per week (Figure 1). 