Cytomegalovirus viral load kinetics predict cytomegalovirus end-organ disease and mortality after hematopoietic cell transplant Journal Article
| Authors: | Stern, A.; Su, Y.; Dumke, H.; Fang, J.; Tamari, R.; Jakubowski, A.; Cho, C.; Giralt, S.; Perales, M. A.; Papanicolaou, G. A. |
| Article Title: | Cytomegalovirus viral load kinetics predict cytomegalovirus end-organ disease and mortality after hematopoietic cell transplant |
| Abstract: | BACKGROUND: We investigatedthe association between time-averaged area under the curve (AAUC) of cytomegalovirus (CMV) viral load (VL) by day 100 and overall survival (OS) at 1-year after hematopoietic cell transplantation (HCT). METHODS: In a retrospective cohort study, including patients receiving HCT between June 2010 and December 2017 from Memorial Sloan Kettering Cancer Center, AAUC was calculated for patients with detected VL. Patients were categorized into non-controllers (Q4) and controllers (Q1-Q3) using the highest AAUC quartile as cutoff. Cox models were used to estimate the association between AAUC and OS. Patients with non-detected CMV VL were categorized into elite-controllers (recipient+ [R+] or R-/donor+ [D+]) and R-/D-. RESULTS: The study (N = 952) included 282 controllers, 93 non-controllers, 275 elite-controllers, and 302 R-/D-. OS was 80.1% and 58.1% for controllers and non-controllers, respectively. In multivariable models, non-controllers had worse OS versus controllers (adjusted hazard ratio [HR] = 2.65; 95% confidence interval [CI], 1.71-4.12). In landmark analyses, controllers had similar OS as elite-controllers (HR = 1.26; 95% CI, .83-1.91) or R-/D- (HR = 0.98; 95% CI, .64-1.5). CONCLUSIONS: Non-controllers had worse OS 1-year post-HCT. Controllers had similar OS as elite-controllers or R-/D-. Future studies are needed to validate our AAUC cutoff across different cohorts and CMV management strategies. © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. |
| Keywords: | overall survival (os); hematopoietic cell transplantation (hct); cytomegalovirus (cmv); averaged area under the curve (aauc); end-organ disease (eod); non-relapse mortality (nrm); viral load (vl) |
| Journal Title: | Journal of Infectious Diseases |
| Volume: | 224 |
| Issue: | 4 |
| ISSN: | 0022-1899 |
| Publisher: | Oxford University Press |
| Date Published: | 2021-08-15 |
| Start Page: | 620 |
| End Page: | 631 |
| Language: | English |
| DOI: | 10.1093/infdis/jiab212 |
| PUBMED: | 33864371 |
| PROVIDER: | scopus |
| PMCID: | PMC8366442 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 November 2021 -- Source: Scopus |
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MSK Authors
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1053Giralt -
238Papanicolaou -
457Jakubowski -
915Perales -
134Cho -
210Tamari -
20Su -
9
Fang -
13
Stern -
2
Dumke
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