INTRODUCTION: Indications for the application of hematopoietic stem cell transplantation (HSCT) from alternative donors have remarkably broadened in scope; however, the incidence of infections that lead to failure of HSCT, such as human herpesvirus-6 (HHV-6) encephalitis, has also increased. METHODS: We analyzed risk factors for symptomatic HHV-6 reactivation and the development of HHV-6 encephalitis in 140 consecutive adult patients who received allogeneic HSCT at our institution. Stem cell sources for the recipients were as follows: related-donor bone marrow in 40, related-donor peripheral blood in 5, unrelated bone marrow in 67, and unrelated cord blood in 28. RESULTS: Symptomatic HHV-6 reactivation occurred in 22 patients (16%), and 11 patients manifested encephalitis. Multivariate Cox proportional hazards regression analysis identified cord blood cell transplantation (CBT) as an independent predictor of HHV-6 reactivation (P = 0.008). Hyponatremia or hypernatremia at the time of HHV-6 reactivation was detected before the development of HHV-6 encephalitis in 2 or 4 patients, respectively. Two patients died of HHV-6 encephalitis and 6 patients died of relapse of underlying diseases. Survival analysis identified higher risk of the disease (P = 0.021) and HHV-6 encephalitis (P = 0.003) as independent risk factors for reduced overall survival. CONCLUSION: In cases involving CBT or unrelated-donor transplantation, patients should be carefully monitored for the symptomatic reactivation of HHV-6.
INTRODUCTION: Indications for the application of hematopoietic stem cell transplantation (HSCT) from alternative donors have remarkably broadened in scope; however, the incidence of infections that lead to failure of HSCT, such as human herpesvirus-6 (HHV-6) encephalitis, has also increased. METHODS: We analyzed risk factors for symptomatic HHV-6 reactivation and the development of HHV-6 encephalitis in 140 consecutive adult patients who received allogeneic HSCT at our institution. Stem cell sources for the recipients were as follows: related-donor bone marrow in 40, related-donor peripheral blood in 5, unrelated bone marrow in 67, and unrelated cord blood in 28. RESULTS: Symptomatic HHV-6 reactivation occurred in 22 patients (16%), and 11 patients manifested encephalitis. Multivariate Cox proportional hazards regression analysis identified cord blood cell transplantation (CBT) as an independent predictor of HHV-6 reactivation (P = 0.008). Hyponatremia or hypernatremia at the time of HHV-6 reactivation was detected before the development of HHV-6 encephalitis in 2 or 4 patients, respectively. Two patients died of HHV-6 encephalitis and 6 patients died of relapse of underlying diseases. Survival analysis identified higher risk of the disease (P = 0.021) and HHV-6 encephalitis (P = 0.003) as independent risk factors for reduced overall survival. CONCLUSION: In cases involving CBT or unrelated-donor transplantation, patients should be carefully monitored for the symptomatic reactivation of HHV-6.
Authors: Swapneel J Patel; Guoyan Zhao; Vinay R Penna; Eugene Park; Elvin J Lauron; Ian B Harvey; Wandy L Beatty; Beatrice Plougastel-Douglas; Jennifer Poursine-Laurent; Daved H Fremont; David Wang; Wayne M Yokoyama Journal: J Virol Date: 2017-04-13 Impact factor: 5.103
Authors: Amanda L Olson; Parastoo B Dahi; Junting Zheng; Sean M Devlin; Marissa Lubin; Anne Marie Gonzales; Sergio A Giralt; Miguel-Angel Perales; Esperanza B Papadopoulos; Doris M Ponce; James W Young; Nancy A Kernan; Andromachi Scaradavou; Richard J O'Reilly; Trudy N Small; Genovefa Papanicolaou; Juliet N Barker Journal: Biol Blood Marrow Transplant Date: 2014-02-16 Impact factor: 5.742
Authors: Emily C Leibovitch; Giovanna S Brunetto; Breanna Caruso; Kaylan Fenton; Joan Ohayon; Daniel S Reich; Steven Jacobson Journal: PLoS One Date: 2014-03-24 Impact factor: 3.240