Human CMV infection is a frequent complication after HSC in children with remarkable morbidity and mortality. Antiviral drugs are relatively efficient but have numerous side effects. They are used as prophylactic, pre-emptive or therapeutic medicines. It is still a matter of debate which option is the best strategy. No uniform procedure has emerged regarding these three options, and new immunologic tools have raised more questions for physicians. To assess the current practice in the management of CMV infection, we sent a questionnaire to the EBMT centers performing hematopoietic SCT (HSCT) in children. Fifty-six out of 196 responded to the questionnaire (28.5%). Quantitative PCR was the most common monitoring tool (44/56). Only 4/56 centers use the pp65 antigenemia alone. All centers used pre-emptive strategy (56/56). 21/56 centers also used prophylactic measures, 13/21 after analysis of donor/receptor serologic status. Ganciclovir was the most common first-line agent for CMV disease (55/56). The most common dose and duration for induction treatment were 5 mg/kg bid (47/55) for 14 days (20/55). There is no uniform procedure for researching resistance strain, antiviral second-line therapy or cell therapy. A harmonization process should enable sound prospective trials to improve prevention, control and cure of CMV disease in children and adolescents.

Chair of EBMT Inborn Error Working Party Molecular Immunology Unit UCL Institute of Child Health London UK

Chair of EBMT Infectious Disease Working Party Paediatric Haematology Oncology Policlinico G B Rossi Verona Italy

Chair of EBMT Paediatric Diseases Working Party St Anna Children's Hospital Vienna Austria

Clinica Pediatrica Università degli Studi di Milano Bicocca Ospedale San Gerardo Monza Italy

Department of Hematology and Immunology Hospital Robert Debre Paris 7 Paris Diderot University Paris France

Department of Pediatric Hematology and Oncology University Hospital Motol 2nd Medical School Charles University Prague Czech Republic

Division of Hematology Department of Internal Medicine 2 University Hospital of Würzburg Würzburg Germany

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