Cytomegalovirus resistance in CD34(+)-selected hematopoietic cell transplant recipients Journal Article
| Authors: | Kim, S. J.; Huang, Y. T.; Foldi, J.; Lee, Y. J.; Maloy, M.; Giralt, S. A.; Jakubowski, A. A.; Papanicolaou, G. A. |
| Article Title: | Cytomegalovirus resistance in CD34(+)-selected hematopoietic cell transplant recipients |
| Abstract: | Background: Cytomegalovirus (CMV) viremia after CD34+-selected hematopoietic stem cell transplant (HCT) often requires prolonged antiviral therapy. We report rates and outcomes of resistant CMV in a contemporary cohort of CD34+-selected HCT recipients managed preemptively. Methods: We retrospectively reviewed 220 consecutive, CMV-seropositive recipients (R+), who received CD34+-selected HCT at Memorial Sloan Kettering Cancer Center between June 2010 and December 2014. Patients were monitored by quantitative CMV PCR and were treated preemptively. CMV resistance was tested by a genotypic assay. Results: One hundred and sixty-one (73%) patients developed CMV viremia and 47 (29% of viremic and 21% of total patients) had CMV resistance testing by one-year from HCT. CMV resistance was confirmed in 19 (12% of viremic and 9% of total) patients and was identified >3 months from HCT in 90% of patients. Twelve patients had mutations in UL97 only; the remaining 7 patients had mutations in UL54 only or UL54 and UL97. By 1 year from HCT, 11 of 19 (58%) patients with mutations had CMV end-organ disease. CMV-related mortality in patients with resistance was 42%. Conclusions: Nine percent of CMV R+, CD34+-selected HCT recipients had resistant CMV by 1 year from HCT. Of 19 patients with resistant CMV, 58% had CMV end-organ disease and 42% died of CMV. Effective strategies for CMV prevention and restoration of CMV immunity are needed for CD34+-selected HCT. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd |
| Keywords: | genotype; hematopoietic stem cell transplantation; cytomegalovirus; resistance; cd34+-selected |
| Journal Title: | Transplant Infectious Disease |
| Volume: | 20 |
| Issue: | 3 |
| ISSN: | 1398-2273 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2018-06-01 |
| Start Page: | e12881 |
| Language: | English |
| DOI: | 10.1111/tid.12881 |
| PROVIDER: | scopus |
| PMCID: | PMC5988949 |
| PUBMED: | 29570237 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 July 2018 -- Source: Scopus |
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50Lee -
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238Papanicolaou -
455Jakubowski -
269Maloy -
28Huang -
4
Foldi -
13
Kim
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