George et al reported the CMV Scoring Index (CSI) for predicting the risk of CMV reactivation in the recipient of an allogeneic stem cell transplant. The authors are from the University of Sydney in Australia.
Patient selection: allogeneic stem cell transplant recipient
Parameters:
(1) CMV seropositivity in the recipient
(2) CMS seropositivity in the donor
(3) type of T-cell depletion
Parameter
Finding
Points
recipient seropositivity
no
0
yes
4
donor seropositivity
no
0
yes
1
T cell depletion
no
0
with ATG
1
with alemtuzumab
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
Score
Risk Group
Risk of Reactivation
0 to 2
low
0%
3 to 5
intermediate
46%
6 or 7
high
68%
If the patient is intermediate risk, then the presence of acute GVHD is associated with a higher rate of CMV reactivation (64% vs 28% if absent).
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