John R. Wingard, MD
Professor and Price Chair of Medicine
Department of Medicine
Professor, Department of Pediatrics
Director, Blood and Bone Marrow Transplant Program
University of Florida Shands Cancer Center
Gainesville, Florida

Jayesh Mehta, MD
Professor of Medicine
The Robert H. Lurie Comprehensive Cancer Center
Director, Hematopoietic Stem Cell Transplant Program
Division of Hematology/Oncology
The Feinberg School of Medicine
Northwestern University
Chicago, Illinois

Release date: April 30, 2009
Expiration date: April 30, 2010

Target Audience

This activity has been designed to meet the educational needs of physicians involved in the treatment of hematopoietic stem cell transplant (HSCT) patients.

Activity Purpose

This activity is intended to assist healthcare professionals in preventing cytomegalovirus (CMV) infection in HSCT recipients and implementing therapeutic strategies that reduce CMV drug resistance.

Statement of Need

Cytomegalovirus (CMV) is an important cause of morbidity and mortality in recipients of hematopoietic stem cell transplant (HSCT). CMV infection occurs in up to 60% of HSCT patients, and CMV disease occurs in 10% of HSCT patients in the preemptive therapy era.1,2  Immunosuppression before and after HSCT causes patients to be particularly vulnerable to opportunistic infections, such as CMV. The clinical manifestations of CMV disease range from gastrointestinal disease to life-threatening pneumonia, myelosuppression, retinitis, and encephalitis.

An understanding of the management of CMV, including prophylaxis and treatment, is especially important considering that many antiviral therapeutic agents have significant hematologic toxicity. Despite great progress in elucidating the pathophysiology of CMV infection and the spectrum of disease in HSCT recipients, diagnostic and therapeutic challenges remain. Thus it is clear that additional research and improved therapies are needed for this persistent pathogen.
1 Razonable RR, Paya CV. Expert Rev Anti Infect Ther. 2004;2:27-41.
2 Nichols WG, Boeckh M. J Clin Virol. 2000;16:25-40.

Learning Objectives

After completing this activity, the participant should be better able to:

  • Identify risk factors for CMV disease in HSCT recipients
  • Describe the direct and indirect effects of CMV infection
  • Outline clinical considerations in late CMV disease
  • Cite current and emerging therapies for CMV prevention and treatment

Accreditation Statement

The Medical College of Wisconsin is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Disclosure of Conflicts of Interest

Consistent with the current Accreditation Council for Continuing Medical Education policy, the CME Provider must be able to show that everyone who is in a position to control the content of an individual educational activity has disclosed all relevant financial relationships.  The CME Provider has a mechanism in place to identify and resolve any conflicts of interest discovered in the disclosure process.

The faculty reported the following financial relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Dr. John R. Wingard: Consulting Fees: Merck & Co., Inc, and Pfizer Inc. Speakers’ Bureau: Astellas Pharma Inc.: Merck & Co., Inc., and Pfizer Inc.

Dr. Jayesh Mehta: Speakers’ Bureau: ViroPharma Incorporated.

The planners and managers reported the following financial relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
Elise M. Paxson has no affiliations with commercial interests to disclose.
Laura Altobelli, MS, has no affiliations with commercial interests to disclose.
Marcus Weathersby, has no affiliations with commercial interests to disclose.

Method of Participation

There are no fees for participating in this CME activity. To receive credit during the period April 30, 2009 to April 30, 2010, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, (3) complete the posttest, and (4) complete the activity evaluation form, including the certificate information section.

The posttest can be accessed at the end of the activity.


The Internet was selected as the instructional format to accommodate the learning preferences of a significant portion of the target audience.


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