Clinical outcomes of allogeneic hematopoietic stem cell transplant recipients developing Cytomegalovirus DNAemia prior to engraftment.

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Abstrakt

Tytuł:: Clinical outcomes of allogeneic hematopoietic stem cell transplant recipients developing Cytomegalovirus DNAemia prior to engraftment.
Autorzy:: Solano C; Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.; Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain.
Vázquez L; Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain.
Giménez E; Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
de la Cámara R; Hematology Department, Hospital de la Princesa, Madrid, Spain.
Albert E; Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
Rovira M; Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain.
Espigado I; Hematology Department, Hospital Virgen del Rocío, Sevilla, Spain.
Calvo CM; Hematology Department, Hospital Universitario Reina Sofía, Córdoba, Spain.
López-Jiménez J; Hematology Department, Hospital Ramón y Cajal, Madrid, Spain.
Suárez-Lledó M; Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain.
Chinea A; Hematology Department, Hospital Ramón y Cajal, Madrid, Spain.
Esquirol A; Hematology Department, Hospital Sant Creu i Sant Pau, Barcelona, Spain.
Pérez A; Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain.
Bermúdez A; Department of Hematology, Hospital Marques de Valdecilla, Santander, Spain.
Saldaña R; Hematology Department, Hospital Universitario de Jerez, Cádiz, Spain.
Heras I; Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonación, IMIB, Universidad de Murcia, Murcia, Spain.
González-Huerta AJ; Hematology-Stem cell Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo IISPA. IUOPA, Oviedo, Spain.
Torrado T; Hematology Department, Complejo Hospitalario Universitario, Vigo, Spain.
Batlle M; Hematology Department, Hospital Germans Trias i Pujol, Barcelona, Spain.
Jiménez S; Hematology Department, Hospital Universitario Doctor Negrín de Gran Canaria, Las Palmas, Spain.
Vallejo C; Hematology Department Hospital Universitario Donostia-Aránzazu, San Sebastián, Spain.
Barba P; Hematology Department Hospital Universitario Vall de Hebrón, Barcelona, Spain.
Cuesta MÁ; Hematology Department, Hospital Regional Universitario, Málaga, Spain.
Piñana JL; Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain, CIBERONC, Instituto Carlos III, Madrid, Spain.
Navarro D; Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain. .; Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain. .
Corporate Authors:: Spanish Group of Hematopoietic Transplantation and Cell Therapy (GETH)
Źródło:: Bone marrow transplantation [Bone Marrow Transplant] 2021 Jun; Vol. 56 (6), pp. 1281-1290. Date of Electronic Publication: 2020 Dec 15.
Typ publikacji:: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: <2003->: London : Nature Publishing Group
Original Publication: Basingstoke, Hampshire : Scientific & Medical Division, Macmillan Press, c1986-
MeSH Terms:: Cytomegalovirus Infections*
Hematopoietic Stem Cell Transplantation*/adverse effects
Cytomegalovirus/genetics ; DNA, Viral ; Humans ; Retrospective Studies ; Transplant Recipients ; Transplantation, Homologous
References:: Ljungman P, de la Camara R, Robin C, Crocchiolo R, Einsele H, Hill JA, et al. Guidelines for the management of cytomegalovirus infection in patients with haematological malignancies and after stem cell transplantation from the 2017 European Conference on Infections in Leukaemia (ECIL 7). Lancet Infect Dis. 2019;9:e260–e272. (PMID: 10.1016/S1473-3099(19)30107-0)
Teira P, Battiwalla M, Ramanathan M, Barrett AJ, Ahn KW, Chen M, et al. Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era: a CIBMTR analysis. Blood. 2016;127:2427–38. (PMID: 10.1182/blood-2015-11-679639)
Green ML, Leisenring W, Xie H, Mast TC, Cui Y, Sandmaier BM, et al. Cytomegalovirus viral load and mortality after haemopoietic stem cell transplantation in the era of pre-emptive therapy: a retrospective cohort study. Lancet Hematol. 2016;3:e119–e127. (PMID: 10.1016/S2352-3026(15)00289-6)
Solano C, Gimenez E, Pinana JL, Albert E, Vinuesa V, Hernández-Boluda JC et al. Impact of cytomegalovirus DNAemia on overall and non-relapse mortality in allogeneic stem cell transplant recipients. Transpl Infect Dis. 2017;19, https://doi.org/10.1111/tid.12717 .
Giménez E, Torres I, Albert E, Piñana JL, Hernández‐Boluda JC, Solano C, et al. Cytomegalovirus (CMV) infection and risk of mortality in allogeneic hematopoietic stem cell transplantation (Allo‐HSCT): A systematic review, meta‐analysis, and meta‐regression analysis. Am J Transpl. 2019;19:2479–94. (PMID: 10.1111/ajt.15515)
Marty FM, Ljungman P, Chemaly RF, Maertens J, Dadwal SS, Duarte RF, et al. Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantation. N Engl J Med. 2017;377:2433–44. (PMID: 10.1056/NEJMoa1706640)
Solano C, Giménez E, Albert E, Mateo EM, Gómez M, Goterris R, et al. Pre-engraftment cytomegalovirus DNAemia in allogeneic hematopoietic stem cell transplant recipients: incidence, risk factors, and clinical outcomes. Bone Marrow Transpl. 2019;54:90–98. (PMID: 10.1038/s41409-018-0251-0)
Martin I, Valsamakis A, Gladstone D, Jones R, Ambinder R, Avery RK. Cytomegalovirus in adult allogeneic blood and marrow transplant patients before or around the period of neutrophil recovery: a single-center, retrospective, descriptive study. Open Forum Infect Dis. 2020;7:ofaa081. (PMID: 10.1093/ofid/ofaa081)
Solano C, Giménez E, Piñana JL, Vinuesa V, Poujois S, Zaragoza S, et al. Preemptive antiviral therapy for CMV infection in allogeneic stem cell transplant recipients guided by the viral doubling time in the blood. Bone Marrow Transpl. 2016;51:718–21. (PMID: 10.1038/bmt.2015.303)
Muñoz-Cobo B, Solano C, Costa E, Bravo D, Clari MÁ, Benet I, et al. Dynamics of cytomegalovirus (CMV) plasma DNAemia in initial and recurrent episodes of active CMV infection in the allogeneic stem cell transplantation setting: implications for designing preemptive antiviral therapy strategies. Biol Blood Marrow Transpl. 2011;17:1602–11. (PMID: 10.1016/j.bbmt.2011.08.014)
Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HL-A-matched sibling donors. Transplantation. 1974;18:295–304. (PMID: 10.1097/00007890-197410000-00001)
Ljungman P, Griffiths P, Paya C. Definitions of cytomegalovirus infection and disease in transplant recipients. Clin Infect Dis. 2002;34:1094–7. (PMID: 10.1086/339329)
Sorror ML. How I assess comorbidities before hematopoietic cell transplantation. Blood. 2013;121:2854–63. (PMID: 10.1182/blood-2012-09-455063)
Styczyński J, Tridello G, Koster L, Iacobelli S, van Biezen A, van der Werf S, et al. Death after hematopoietic stem cell transplantation: changes over calendar year time, infections and associated factors. Bone Marrow Transpl. 2020;55:126–36. (PMID: 10.1038/s41409-019-0624-z)
Cromer D, Tey SK, Khanna R, Davenport MP. Estimating cytomegalovirus growth rates by using only a single point. J Virol. 2013;87:3376–81. (PMID: 10.1128/JVI.02821-12)
Vinuesa V, Giménez E, Solano C, Gimeno C, Navarro D. Would kinetic analyses of plasma cytomegalovirus DNA load help to reach consensus criteria for triggering the initiation of preemptive antiviral therapy in transplant recipients? Clin Infect Dis. 2016;63:1533–5. (PMID: 10.1093/cid/ciw608)
Navarro D, Amat P, de la Cámara R, López J, Vázquez L, Serrano D, et al. Efficacy and safety of a preemptive antiviral therapy strategy based on combined virological and immunological monitoring for active cytomegalovirus infection in allogeneic stem cell transplant recipients. Open Forum Infect Dis. 2016;3:ofw107. (PMID: 10.1093/ofid/ofw107)
Solano C, Vázquez L, Giménez E, de la Cámara R, Albert E, Rovira M, et al. Cytomegalovirus DNAemia and risk of mortality in allogeneic hematopoietic stem cell transplantation: analysis from the Spanish Hematopoietic Transplantation and Cell Therapy Group. Am J Transpl. 2020, https://doi.org/10.1111/ajt.16147 .
Substance Nomenclature:: 0 (DNA, Viral)
Entry Date(s):: Date Created: 20201215 Date Completed: 20210630 Latest Revision: 20210731
Update Code:: 20240104
DOI:: 10.1038/s41409-020-01157-x
PMID:: 33319853
: Czasopismo naukowe

There is limited information on the impact of CMV DNAemia episodes developing prior to engraftment (pre-CMV DNAemia) on clinical outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT). This issue was addressed in the current retrospective multicenter study including 878 patients. All participant centers used preemptive antiviral therapy strategies for prevention of CMV disease. CMV DNA load in blood was monitored by real-time PCR assays. A total of 144 patients (cumulative incidence 16.5%, 95% CI, 14%-19%) had an episode of pre-CMV DNAemia at a median of 10 days after allo-HSCT. Patients who developed pre-CMV DNAemia had a significantly higher (P = < 0.001) probability of recurrent episodes (50%) than those who experienced post-CMV DNAemia (32.9%); Nevertheless, the incidence of CMV disease was comparable (P = 0.52). Cumulative incidences of overall mortality (OM) and non-relapse mortality (NRM) at 1-year after allo-HSCT were 32% (95% CI, 29-35%) and 23% (95% CI 20-26%), respectively. The risk of OM and NRM in adjusted models appeared comparable in patients developing a single episode of CMV DNAemia, regardless of whether it occurred before or after engraftment, in patients with pre- and post-engraftment CMV DNAemia episodes or in those without CMV DNAemia.

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