Cytomegalovirus infection after CD34(+)-selected hematopoietic cell transplantation Journal Article
| Authors: | Huang, Y. T.; Neofytos, D.; Foldi, J.; Kim, S. J.; Maloy, M.; Chung, D.; Castro-Malaspina, H.; Giralt, S. A.; Papadopoulos, E.; Perales, M. A.; Jakubowski, A. A.; Papanicolaou, G. A. |
| Article Title: | Cytomegalovirus infection after CD34(+)-selected hematopoietic cell transplantation |
| Abstract: | The effectiveness of preemptive treatment (PET) for cytomegalovirus (CMV) in recipients of ex vivo T cell-depleted (TCD) hematopoietic cell transplantation (HCT) by CD34(+) selection is not well defined. We analyzed 213 adults who received TCD-HCT at our institution from June 2010 through May 2014. Patients were monitored by a CMV quantitative PCR assay if recipient (R) or donor (D) were CMV seropositive. CMV viremia occurred early (median, 27 days after HCT) in 91 of 213 (42.7%) patients for a 180-day cumulative incidence of 84.5%, 61.8%, and 0 for R+/D+, R+/D-, and R-/D+ patients, respectively. CMV disease occurred in 5% of patients. In Cox regression analysis, R+/D+ status was associated with increased risk for CMV viremia compared with R+/D- (hazard ratio [HR], 1.79, 95% confidence interval [CI], 1.16 to 2.76, P =.01), whereas matched unrelated donor allograft was associated with decreased risk (HR, .62; 95% CI, .39 to .97, P =.04). Of 91 patients with CMV viremia, 52 (57%) had persistent viremia (>28 days duration). Time lag from detection of CMV viremia to PET was associated with incremental risk for persistent viremia (HR, 1.09; 95% CI, 1.01 to 1.18; P =.03). Overall, 166 of 213 (77.9%) patients were alive 1 year after HCT, with no difference between patients with and without CMV viremia or among the different CMV serostatus pairs (P = not significant). CMV viremia occurred in 70% of R + TCD-HCT. Delay in PET initiation was associated with persistent viremia. With PET, CMV R/D serostatus did not adversely impact survival in TCD-HCT on 1-year survival in the present cohort. (C) 2016 American Society for Blood and Marrow Transplantation. |
| Keywords: | transplantation; hematopoietic cell; complications; epidemiology; t cell depletion; cytomegalovirus; disease; peripheral-blood; risk-factors; bone-marrow; reactivation; unrelated donors; preemptive therapy; cmv viremia; cmv-seropositive recipients; serostatus |
| Journal Title: | Biology of Blood and Marrow Transplantation |
| Volume: | 22 |
| Issue: | 8 |
| ISSN: | 1083-8791 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2016-08-01 |
| Start Page: | 1480 |
| End Page: | 1486 |
| Language: | English |
| ACCESSION: | WOS:000380417400021 |
| DOI: | 10.1016/j.bbmt.2016.05.003 |
| PROVIDER: | wos |
| PMCID: | PMC4949094 |
| PUBMED: | 27178374 |
| Notes: | Article -- Source: Wos |
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MSK Authors
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648Giralt -
160Papanicolaou -
342Papadopoulos -
369Jakubowski -
494Perales -
291Castro-Malaspina -
191Maloy -
13
Chung -
28Huang -
6
Neofytos -
4
Foldi -
12
Kim
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