Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Prevention of viral infections in hematopoietic cell transplant recipients

John R Wingard, MD
Section Editor
Kieren A Marr, MD
Deputy Editor
Anna R Thorner, MD


Hematopoietic cell transplant (HCT) recipients, especially those who have received allogeneic transplants, are at increased risk for a variety of infections depending upon their degree of immunosuppression and exposures. The term "hematopoietic cell transplantation" will be used throughout this topic as a general term to cover transplantation of hematopoietic cells from any source (eg, bone marrow, peripheral blood, umbilical cord blood). (See "Sources of hematopoietic stem cells".)

Infection in HCT recipients is associated with high morbidity and mortality. Viruses of major importance in HCT recipients include herpes simplex virus (HSV), varicella-zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), respiratory viruses (eg, influenza, parainfluenza, respiratory syncytial virus, adenovirus), human herpes virus 6 (HHV-6), hepatitis B, and hepatitis C. Antiviral prophylaxis or preemptive therapy against some of these viruses is recommended for HCT recipients and will be discussed here. An overview of infections following HCT, evaluation for infections before HCT, prophylaxis of other infections in HCT recipients, and immunizations in HCT candidates and recipients are presented separately. (See "Overview of infections following hematopoietic cell transplantation" and "Evaluation for infection before hematopoietic cell transplantation" and "Prevention of infections in hematopoietic cell transplant recipients" and "Prophylaxis of invasive fungal infections in adult hematopoietic cell transplant recipients" and "Prophylaxis of infection during chemotherapy-induced neutropenia in high-risk adults" and "Immunizations in hematopoietic cell transplant candidates and recipients".)


In 2009, guidelines for preventing infectious complications after HCT were published, which represent the collaboration of several organizations from Europe and North America, including the European Blood and Marrow Transplant Group, the American Society of Blood and Marrow Transplantation, the Canadian Blood and Marrow Transplant Group, the Infectious Diseases Society of America, and the United States Centers for Disease Control and Prevention [1]. Our recommendations are generally in keeping with these guidelines.

The National Comprehensive Cancer Network has also published guidelines for the prevention and treatment of cancer-related infections [2].


The pretransplantation evaluation is designed to prevent posttransplant infections by excluding unsuitable donors and defining specific infection control policies and antimicrobial prophylaxis and therapy regimens, which will be necessary after transplantation. Laboratory testing for evidence of past infectious exposures is performed to detect asymptomatic infection in the HCT donor or candidate. Some tests are recommended for all HCT donors and candidates, whereas others are appropriate in selected individuals with epidemiologic risk factors (table 1) [1,3]. Serologic testing is used as an indicator of significant past exposures.

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:

Subscribers log in here

Literature review current through: Nov 2017. | This topic last updated: Nov 28, 2017.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc.
  1. Tomblyn M, Chiller T, Einsele H, et al. Guidelines for preventing infectious complications among hematopoietic cell transplantation recipients: a global perspective. Biol Blood Marrow Transplant 2009; 15:1143.
  2. National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Prevention and treatment of cancer-related infections. Version 2.2014. http://www.nccn.org (Accessed on November 06, 2014).
  3. US Food and Drug Administration. Testing HCT/P donors: Specific requirements. http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/TissueSafety/ucm151757.htm (Accessed on December 02, 2014).
  4. Angarone M, Ison MG. Prevention and early treatment of opportunistic viral infections in patients with leukemia and allogeneic stem cell transplantation recipients. J Natl Compr Canc Netw 2008; 6:191.
  5. Erard V, Wald A, Corey L, et al. Use of long-term suppressive acyclovir after hematopoietic stem-cell transplantation: impact on herpes simplex virus (HSV) disease and drug-resistant HSV disease. J Infect Dis 2007; 196:266.
  6. Yahav D, Gafter-Gvili A, Muchtar E, et al. Antiviral prophylaxis in haematological patients: systematic review and meta-analysis. Eur J Cancer 2009; 45:3131.
  7. Saral R, Burns WH, Laskin OL, et al. Acyclovir prophylaxis of herpes-simplex-virus infections. N Engl J Med 1981; 305:63.
  8. Gluckman E, Lotsberg J, Devergie A, et al. Prophylaxis of herpes infections after bone-marrow transplantation by oral acyclovir. Lancet 1983; 2:706.
  9. Wade JC, Newton B, Flournoy N, Meyers JD. Oral acyclovir for prevention of herpes simplex virus reactivation after marrow transplantation. Ann Intern Med 1984; 100:823.
  10. Liesveld JL, Abboud CN, Ifthikharuddin JJ, et al. Oral valacyclovir versus intravenous acyclovir in preventing herpes simplex virus infections in autologous stem cell transplant recipients. Biol Blood Marrow Transplant 2002; 8:662.
  11. Warkentin DI, Epstein JB, Campbell LM, et al. Valacyclovir versus acyclovir for HSV prophylaxisin neutropenic patients. Ann Pharmacother 2002; 36:1525.
  12. Schuchter LM, Wingard JR, Piantadosi S, et al. Herpes zoster infection after autologous bone marrow transplantation. Blood 1989; 74:1424.
  13. Boeckh M, Kim HW, Flowers ME, et al. Long-term acyclovir for prevention of varicella zoster virus disease after allogeneic hematopoietic cell transplantation--a randomized double-blind placebo-controlled study. Blood 2006; 107:1800.
  14. Selby PJ, Powles RL, Easton D, et al. The prophylactic role of intravenous and long-term oral acyclovir after allogeneic bone marrow transplantation. Br J Cancer 1989; 59:434.
  15. Erard V, Guthrie KA, Varley C, et al. One-year acyclovir prophylaxis for preventing varicella-zoster virus disease after hematopoietic cell transplantation: no evidence of rebound varicella-zoster virus disease after drug discontinuation. Blood 2007; 110:3071.
  16. Centers for Disease Control and Prevention (CDC). FDA approval of an extended period for administering VariZIG for postexposure prophylaxis of varicella. MMWR Morb Mortal Wkly Rep 2012; 61:212.
  17. Ljungman P. The role of cytomegalovirus serostatus on outcome of hematopoietic stem cell transplantation. Curr Opin Hematol 2014; 21:466.
  18. Meyers JD, Leszczynski J, Zaia JA, et al. Prevention of cytomegalovirus infection by cytomegalovirus immune globulin after marrow transplantation. Ann Intern Med 1983; 98:442.
  19. Raanani P, Gafter-Gvili A, Paul M, et al. Immunoglobulin prophylaxis in hematopoietic stem cell transplantation: systematic review and meta-analysis. J Clin Oncol 2009; 27:770.
  20. Ruutu T, Ljungman P, Brinch L, et al. No prevention of cytomegalovirus infection by anti-cytomegalovirus hyperimmune globulin in seronegative bone marrow transplant recipients. The Nordic BMT Group. Bone Marrow Transplant 1997; 19:233.
  21. Hansen JA, Gooley TA, Martin PJ, et al. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med 1998; 338:962.
  22. Goodrich JM, Mori M, Gleaves CA, et al. Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplantation. N Engl J Med 1991; 325:1601.
  23. Goodrich JM, Bowden RA, Fisher L, et al. Ganciclovir prophylaxis to prevent cytomegalovirus disease after allogeneic marrow transplant. Ann Intern Med 1993; 118:173.
  24. Winston DJ, Ho WG, Bartoni K, et al. Ganciclovir prophylaxis of cytomegalovirus infection and disease in allogeneic bone marrow transplant recipients. Results of a placebo-controlled, double-blind trial. Ann Intern Med 1993; 118:179.
  25. Reusser P, Gambertoglio JG, Lilleby K, Meyers JD. Phase I-II trial of foscarnet for prevention of cytomegalovirus infection in autologous and allogeneic marrow transplant recipients. J Infect Dis 1992; 166:473.
  26. Meyers JD, Reed EC, Shepp DH, et al. Acyclovir for prevention of cytomegalovirus infection and disease after allogeneic marrow transplantation. N Engl J Med 1988; 318:70.
  27. Prentice HG, Gluckman E, Powles RL, et al. Impact of long-term acyclovir on cytomegalovirus infection and survival after allogeneic bone marrow transplantation. European Acyclovir for CMV Prophylaxis Study Group. Lancet 1994; 343:749.
  28. Prentice HG, Gluckman E, Powles RL, et al. Long-term survival in allogeneic bone marrow transplant recipients following acyclovir prophylaxis for CMV infection. The European Acyclovir for CMV Prophylaxis Study Group. Bone Marrow Transplant 1997; 19:129.
  29. Winston DJ, Yeager AM, Chandrasekar PH, et al. Randomized comparison of oral valacyclovir and intravenous ganciclovir for prevention of cytomegalovirus disease after allogeneic bone marrow transplantation. Clin Infect Dis 2003; 36:749.
  30. Ljungman P, de La Camara R, Milpied N, et al. Randomized study of valacyclovir as prophylaxis against cytomegalovirus reactivation in recipients of allogeneic bone marrow transplants. Blood 2002; 99:3050.
  31. Boeckh M, Nichols WG, Chemaly RF, et al. Valganciclovir for the prevention of complications of late cytomegalovirus infection after allogeneic hematopoietic cell transplantation: a randomized trial. Ann Intern Med 2015; 162:1.
  32. Chemaly RF, Ullmann AJ, Stoelben S, et al. Letermovir for cytomegalovirus prophylaxis in hematopoietic-cell transplantation. N Engl J Med 2014; 370:1781.
  33. Lischka P, Michel D, Zimmermann H. Characterization of Cytomegalovirus Breakthrough Events in a Phase 2 Prophylaxis Trial of Letermovir (AIC246, MK 8228). J Infect Dis 2016; 213:23.
  34. MK-8228 (letermovir) versus placebo in the prevention of clinically-significant cytomegalovirus (CMV) infection in adult, CMV-seropositive allogeneic hematopoietic stem cell transplant recipients (MK-8228-001) https://clinicaltrials.gov/ct2/show/study/NCT02137772?term=letermovir&rank=2&show_locs=Y#locn (Accessed on January 10, 2016).
  35. Marty FM, Ljungman PT, Chemaly RF, et al. A phase III randomized, double-blind, placebo-controlled trial of letermovir (LET) for prevention of cytomegalovirus (CMV) infection. BMT Tandem Meetings, February 22-26, 2017, Orlando, Florida. https://bmt.confex.com/tandem/2017/meetingapp.cgi/Paper/9781 (Accessed on April 5, 2017).
  36. Marty FM, Winston DJ, Rowley SD, et al. CMX001 to prevent cytomegalovirus disease in hematopoietic-cell transplantation. N Engl J Med 2013; 369:1227.
  37. Winston DJ, Young JA, Pullarkat V, et al. Maribavir prophylaxis for prevention of cytomegalovirus infection in allogeneic stem cell transplant recipients: a multicenter, randomized, double-blind, placebo-controlled, dose-ranging study. Blood 2008; 111:5403.
  38. Marty FM, Ljungman P, Papanicolaou GA, et al. Maribavir prophylaxis for prevention of cytomegalovirus disease in recipients of allogeneic stem-cell transplants: a phase 3, double-blind, placebo-controlled, randomised trial. Lancet Infect Dis 2011; 11:284.
  39. Milano F, Pergam SA, Xie H, et al. Intensive strategy to prevent CMV disease in seropositive umbilical cord blood transplant recipients. Blood 2011; 118:5689.
  40. Schmidt-Hieber M, Schwarck S, Stroux A, et al. Immune reconstitution and cytomegalovirus infection after allogeneic stem cell transplantation: the important impact of in vivo T cell depletion. Int J Hematol 2010; 91:877.
  41. Boeckh M, Gooley TA, Myerson D, et al. Cytomegalovirus pp65 antigenemia-guided early treatment with ganciclovir versus ganciclovir at engraftment after allogeneic marrow transplantation: a randomized double-blind study. Blood 1996; 88:4063.
  42. PREVYMIS (letermovir) tablets, for oral use; PREVYMIS (letermovir) injection, for intravenous use. US Food and Drug Administration (FDA) approved product information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/209939Orig1s000,209940Orig1s000lbl.pdf (Accessed on November 09, 2017).
  43. US Food and Drug Administration. Division of Drug Information. http://s2027422842.t.en25.com/e/es?s=2027422842&e=17131&elqTrackId=B1F0B909CCF90C71B9C490C37BFE6647&elq=20ae6833fc624da7bf856ded4b188955&elqaid=1266&elqat=1 (Accessed on November 09, 2017).
  44. Letermovir (Prevymis) Health Canada Product Monograph available by query of the Health Canada Drug Product Database. https://health-products.canada.ca/dpd-bdpp/index-eng.jsp (Accessed on November 21, 2017).
  45. Kropeit D, von Richter O, Stobernack HP, et al. Pharmacokinetics and Safety of Letermovir Coadministered With Cyclosporine A or Tacrolimus in Healthy Subjects. Clin Pharmacol Drug Dev 2017.
  46. Chimerix announces top-line results from phase 3 SUPPRESS trial of brincidofovir. http://ir.chimerix.com/releasedetail.cfm?releaseid=948172 (Accessed on January 10, 2016).
  47. Boeckh M, Leisenring W, Riddell SR, et al. Late cytomegalovirus disease and mortality in recipients of allogeneic hematopoietic stem cell transplants: importance of viral load and T-cell immunity. Blood 2003; 101:407.
  48. Fries BC, Riddell SR, Kim HW, et al. Cytomegalovirus disease before hematopoietic cell transplantation as a risk for complications after transplantation. Biol Blood Marrow Transplant 2005; 11:136.
  49. Broers AE, van Der Holt R, van Esser JW, et al. Increased transplant-related morbidity and mortality in CMV-seropositive patients despite highly effective prevention of CMV disease after allogeneic T-cell-depleted stem cell transplantation. Blood 2000; 95:2240.
  50. Einsele H, Ehninger G, Hebart H, et al. Polymerase chain reaction monitoring reduces the incidence of cytomegalovirus disease and the duration and side effects of antiviral therapy after bone marrow transplantation. Blood 1995; 86:2815.
  51. Emery VC, Sabin CA, Cope AV, et al. Application of viral-load kinetics to identify patients who develop cytomegalovirus disease after transplantation. Lancet 2000; 355:2032.
  52. Green ML, Leisenring W, Stachel D, et al. Efficacy of a viral load-based, risk-adapted, preemptive treatment strategy for prevention of cytomegalovirus disease after hematopoietic cell transplantation. Biol Blood Marrow Transplant 2012; 18:1687.
  53. Stoelben S, Arns W, Renders L, et al. Preemptive treatment of Cytomegalovirus infection in kidney transplant recipients with letermovir: results of a Phase 2a study. Transpl Int 2014; 27:77.
  54. Nichols WG, Corey L, Gooley T, et al. Rising pp65 antigenemia during preemptive anticytomegalovirus therapy after allogeneic hematopoietic stem cell transplantation: risk factors, correlation with DNA load, and outcomes. Blood 2001; 97:867.
  55. Springer KL, Chou S, Li S, et al. How evolution of mutations conferring drug resistance affects viral dynamics and clinical outcomes of cytomegalovirus-infected hematopoietic cell transplant recipients. J Clin Microbiol 2005; 43:208.
  56. Reusser P, Einsele H, Lee J, et al. Randomized multicenter trial of foscarnet versus ganciclovir for preemptive therapy of cytomegalovirus infection after allogeneic stem cell transplantation. Blood 2002; 99:1159.
  57. Mattes FM, Hainsworth EG, Geretti AM, et al. A randomized, controlled trial comparing ganciclovir to ganciclovir plus foscarnet (each at half dose) for preemptive therapy of cytomegalovirus infection in transplant recipients. J Infect Dis 2004; 189:1355.
  58. Ljungman P, Deliliers GL, Platzbecker U, et al. Cidofovir for cytomegalovirus infection and disease in allogeneic stem cell transplant recipients. The Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Blood 2001; 97:388.
  59. Pescovitz MD, Rabkin J, Merion RM, et al. Valganciclovir results in improved oral absorption of ganciclovir in liver transplant recipients. Antimicrob Agents Chemother 2000; 44:2811.
  60. Chawla JS, Ghobadi A, Mosley J 3rd, et al. Oral valganciclovir versus ganciclovir as delayed pre-emptive therapy for patients after allogeneic hematopoietic stem cell transplant: a pilot trial (04-0274) and review of the literature. Transpl Infect Dis 2012; 14:259.
  61. van der Heiden PL, Kalpoe JS, Barge RM, et al. Oral valganciclovir as pre-emptive therapy has similar efficacy on cytomegalovirus DNA load reduction as intravenous ganciclovir in allogeneic stem cell transplantation recipients. Bone Marrow Transplant 2006; 37:693.
  62. Barkam C, Kamal H, Dammann E, et al. Improving safety of preemptive therapy with oral valganciclovir for cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation. Bone Marrow Res 2012; 2012:874601.
  63. Ruiz-Camps I, Len O, de la Cámara R, et al. Valganciclovir as pre-emptive therapy for cytomegalovirus infection in allogeneic haematopoietic stem cell transplant recipients. Antivir Ther 2011; 16:951.
  64. Einsele H, Reusser P, Bornhäuser M, et al. Oral valganciclovir leads to higher exposure to ganciclovir than intravenous ganciclovir in patients following allogeneic stem cell transplantation. Blood 2006; 107:3002.
  65. Kharfan-Dabaja MA, Boeckh M, Wilck MB, et al. A novel therapeutic cytomegalovirus DNA vaccine in allogeneic haemopoietic stem-cell transplantation: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis 2012; 12:290.
  66. La Rosa C, Longmate J, Martinez J, et al. MVA vaccine encoding CMV antigens safely induces durable expansion of CMV-specific T cells in healthy adults. Blood 2017; 129:114.
  67. Nakamura R, La Rosa C, Longmate J, et al. Viraemia, immunogenicity, and survival outcomes of cytomegalovirus chimeric epitope vaccine supplemented with PF03512676 (CMVPepVax) in allogeneic haemopoietic stem-cell transplantation: randomised phase 1b trial. Lancet Haematol 2016; 3:e87.
  68. Dole K, Segal FP, Feire A, et al. A First-in-Human Study To Assess the Safety and Pharmacokinetics of Monoclonal Antibodies against Human Cytomegalovirus in Healthy Volunteers. Antimicrob Agents Chemother 2016; 60:2881.
  69. Kanakry JA, Kasamon YL, Bolaños-Meade J, et al. Absence of post-transplantation lymphoproliferative disorder after allogeneic blood or marrow transplantation using post-transplantation cyclophosphamide as graft-versus-host disease prophylaxis. Biol Blood Marrow Transplant 2013; 19:1514.
  70. Styczynski J, Reusser P, Einsele H, et al. Management of HSV, VZV and EBV infections in patients with hematological malignancies and after SCT: guidelines from the Second European Conference on Infections in Leukemia. Bone Marrow Transplant 2009; 43:757.
  71. van Esser JW, Niesters HG, van der Holt B, et al. Prevention of Epstein-Barr virus-lymphoproliferative disease by molecular monitoring and preemptive rituximab in high-risk patients after allogeneic stem cell transplantation. Blood 2002; 99:4364.
  72. Kinch A, Oberg G, Arvidson J, et al. Post-transplant lymphoproliferative disease and other Epstein-Barr virus diseases in allogeneic haematopoietic stem cell transplantation after introduction of monitoring of viral load by polymerase chain reaction. Scand J Infect Dis 2007; 39:235.
  73. Rubin LG, Levin MJ, Ljungman P, et al. 2013 IDSA clinical practice guideline for vaccination of the immunocompromised host. Clin Infect Dis 2014; 58:e44.
  74. Fiore AE, Fry A, Shay D, et al. Antiviral agents for the treatment and chemoprophylaxis of influenza --- recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2011; 60:1.
  75. Harper SA, Bradley JS, Englund JA, et al. Seasonal influenza in adults and children--diagnosis, treatment, chemoprophylaxis, and institutional outbreak management: clinical practice guidelines of the Infectious Diseases Society of America. Clin Infect Dis 2009; 48:1003.
  76. Bright RA, Medina MJ, Xu X, et al. Incidence of adamantane resistance among influenza A (H3N2) viruses isolated worldwide from 1994 to 2005: a cause for concern. Lancet 2005; 366:1175.
  77. Bright RA, Shay DK, Shu B, et al. Adamantane resistance among influenza A viruses isolated early during the 2005-2006 influenza season in the United States. JAMA 2006; 295:891.
  78. Deyde VM, Xu X, Bright RA, et al. Surveillance of resistance to adamantanes among influenza A(H3N2) and A(H1N1) viruses isolated worldwide. J Infect Dis 2007; 196:249.
  79. Vu D, Peck AJ, Nichols WG, et al. Safety and tolerability of oseltamivir prophylaxis in hematopoietic stem cell transplant recipients: a retrospective case-control study. Clin Infect Dis 2007; 45:187.
  80. Chik KW, Li CK, Chan PK, et al. Oseltamivir prophylaxis during the influenza season in a paediatric cancer centre: prospective observational study. Hong Kong Med J 2004; 10:103.
  81. Boeckh M, Englund J, Li Y, et al. Randomized controlled multicenter trial of aerosolized ribavirin for respiratory syncytial virus upper respiratory tract infection in hematopoietic cell transplant recipients. Clin Infect Dis 2007; 44:245.
  82. Khanna N, Widmer AF, Decker M, et al. Respiratory syncytial virus infection in patients with hematological diseases: single-center study and review of the literature. Clin Infect Dis 2008; 46:402.
  83. Sparrelid E, Ljungman P, Ekelöf-Andström E, et al. Ribavirin therapy in bone marrow transplant recipients with viral respiratory tract infections. Bone Marrow Transplant 1997; 19:905.
  84. Ljungman P, Ward KN, Crooks BN, et al. Respiratory virus infections after stem cell transplantation: a prospective study from the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 2001; 28:479.
  85. Nichols WG, Erdman DD, Han A, et al. Prolonged outbreak of human parainfluenza virus 3 infection in a stem cell transplant outpatient department: insights from molecular epidemiologic analysis. Biol Blood Marrow Transplant 2004; 10:58.
  86. Cortez KJ, Erdman DD, Peret TC, et al. Outbreak of human parainfluenza virus 3 infections in a hematopoietic stem cell transplant population. J Infect Dis 2001; 184:1093.
  87. Karron RA, O'Brien KL, Froehlich JL, Brown VA. Molecular epidemiology of a parainfluenza type 3 virus outbreak on a pediatric ward. J Infect Dis 1993; 167:1441.
  88. Dignan F, Alvares C, Riley U, et al. Parainfluenza type 3 infection post stem cell transplant: high prevalence but low mortality. J Hosp Infect 2006; 63:452.
  89. Zambon M, Bull T, Sadler CJ, et al. Molecular epidemiology of two consecutive outbreaks of parainfluenza 3 in a bone marrow transplant unit. J Clin Microbiol 1998; 36:2289.
  90. Jalal H, Bibby DF, Bennett J, et al. Molecular investigations of an outbreak of parainfluenza virus type 3 and respiratory syncytial virus infections in a hematology unit. J Clin Microbiol 2007; 45:1690.
  91. Abdallah A, Rowland KE, Schepetiuk SK, et al. An outbreak of respiratory syncytial virus infection in a bone marrow transplant unit: effect on engraftment and outcome of pneumonia without specific antiviral treatment. Bone Marrow Transplant 2003; 32:195.
  92. Taylor GS, Vipond IB, Caul EO. Molecular epidemiology of outbreak of respiratory syncytial virus within bone marrow transplantation unit. J Clin Microbiol 2001; 39:801.
  93. Harrington RD, Hooton TM, Hackman RC, et al. An outbreak of respiratory syncytial virus in a bone marrow transplant center. J Infect Dis 1992; 165:987.
  94. Lau GK, Lie AK, Kwong YL, et al. A case-controlled study on the use of HBsAg-positive donors for allogeneic hematopoietic cell transplantation. Blood 2000; 96:452.
  95. Lau GK, Liang R, Lee CK, et al. Clearance of persistent hepatitis B virus infection in Chinese bone marrow transplant recipients whose donors were anti-hepatitis B core- and anti-hepatitis B surface antibody-positive. J Infect Dis 1998; 178:1585.
  96. Lau GK, Suri D, Liang R, et al. Resolution of chronic hepatitis B and anti-HBs seroconversion in humans by adoptive transfer of immunity to hepatitis B core antigen. Gastroenterology 2002; 122:614.
  97. Hui CK, Lie A, Au WY, et al. A long-term follow-up study on hepatitis B surface antigen-positive patients undergoing allogeneic hematopoietic stem cell transplantation. Blood 2005; 106:464.
  98. Yeo W, Steinberg JL, Tam JS, et al. Lamivudine in the treatment of hepatitis B virus reactivation during cytotoxic chemotherapy. J Med Virol 1999; 59:263.
  99. Lau GK, Yiu HH, Fong DY, et al. Early is superior to deferred preemptive lamivudine therapy for hepatitis B patients undergoing chemotherapy. Gastroenterology 2003; 125:1742.
  100. Lau GK, He ML, Fong DY, et al. Preemptive use of lamivudine reduces hepatitis B exacerbation after allogeneic hematopoietic cell transplantation. Hepatology 2002; 36:702.
  101. Lalazar G, Rund D, Shouval D. Screening, prevention and treatment of viral hepatitis B reactivation in patients with haematological malignancies. Br J Haematol 2007; 136:699.
  102. Huang H, Li X, Zhu J, et al. Entecavir vs lamivudine for prevention of hepatitis B virus reactivation among patients with untreated diffuse large B-cell lymphoma receiving R-CHOP chemotherapy: a randomized clinical trial. JAMA 2014; 312:2521.
  103. Shang J, Wang H, Sun J, et al. A comparison of lamivudine vs entecavir for prophylaxis of hepatitis B virus reactivation in allogeneic hematopoietic stem cell transplantation recipients: a single-institutional experience. Bone Marrow Transplant 2016; 51:581.
  104. Firpi RJ, Nelson DR. Management of viral hepatitis in hematologic malignancies. Blood Rev 2008; 22:117.
  105. Piekarska A, Zaucha JM, Hellmann A, McDonald GB. Prevention of hepatitis B virus transmission from an infected stem cell donor. Bone Marrow Transplant 2007; 40:399.
  106. Hui CK, Lie A, Au WY, et al. Effectiveness of prophylactic Anti-HBV therapy in allogeneic hematopoietic stem cell transplantation with HBsAg positive donors. Am J Transplant 2005; 5:1437.
  107. Strasser SI, Myerson D, Spurgeon CL, et al. Hepatitis C virus infection and bone marrow transplantation: a cohort study with 10-year follow-up. Hepatology 1999; 29:1893.
  108. Peffault de Latour R, Lévy V, Asselah T, et al. Long-term outcome of hepatitis C infection after bone marrow transplantation. Blood 2004; 103:1618.
  109. Vance EA, Soiffer RJ, McDonald GB, et al. Prevention of transmission of hepatitis C virus in bone marrow transplantation by treating the donor with alpha-interferon. Transplantation 1996; 62:1358.
  110. Surapaneni SN, Hari P, Knox J, et al. Suppressive anti-HCV therapy for prevention of donor to recipient transmission in stem cell transplantation. Am J Gastroenterol 2007; 102:449.
  111. Hsiao HH, Liu YC, Wang HC, et al. Hepatitis C transmission from viremic donors in hematopoietic stem cell transplant. Transpl Infect Dis 2014; 16:1003.
  112. Nakasone H, Kurosawa S, Yakushijin K, et al. Impact of hepatitis C virus infection on clinical outcome in recipients after allogeneic hematopoietic cell transplantation. Am J Hematol 2013; 88:477.
  113. Torres HA, Chong PP, De Lima M, et al. Hepatitis C Virus Infection among Hematopoietic Cell Transplant Donors and Recipients: American Society for Blood and Marrow Transplantation Task Force Recommendations. Biol Blood Marrow Transplant 2015; 21:1870.