1552. Absolute Lymphocyte Threshold: A Simple Readily Available Tool to Predict Risk of Cytomegalovirus Infection After Transplantation

BACKGROUND: Cytomegalovirus (CMV) is a common infection after solid-organ (SOT) and hematologic stem cell transplantation (HSCT). We correlated peripheral blood absolute lymphocyte count (PBALC) with risk of CMV infection in transplant patients. METHODS: Thirty-six SOT and 28 HSCT consecutive patients with plasma CMV viral load (VL) testing for surveillance were enrolled. Clinical variables, including PBALC, were abstracted for correlation with CMV infection. RESULTS: The median age was 54.5 years (IQR 40–63). Forty-three (67.2%) patients developed CMV infection (asymptomatic, 67.4%; CMV syndrome, 14%; gastrointestinal disease, 14%) at median of 4.4 months (IQR 1.4–7.7). Median VL was higher for symptomatic than asymptomatic infection (10,110 vs. 262 IU/mL, P = 0.006). PBALC <830 cells/mm(3) correlated with CMV infection (sensitivity 95%; specificity 71%). Median PBALC among CMV infection patients was lower than those without infection (450 vs. 1,060 cells/mm(3), P < 0.0001). Among SOT patients, PBALC <610 cells/mm(3) correlated with CMV infection (sensitivity 80%; specificity 73%); median PBALC was significantly lower among those who developed CMV infection (270 and 450 vs. 1,120 cells/ mm(3)). Among HSCT recipients, PBALC <830 cells/mm(3) correlated with CMV infection (sensitivity 100%; specificity 80%); median PBALC was lower among those who developed CMV infection (520 and 510 vs. 1,020 cells/ mm(3)) (Table 1). CONCLUSION: In the current era when sophisticated immunologic measures are being proposed as CMV prognosticator, we highlight the clinical importance of a simple readily available PBALC. [Image: see text] DISCLOSURES: All authors: No reported disclosures.