Marie Balsat1, Sylvie Pillet2, Emmanuelle Tavernier3, Victoria Cacheux4, Vanessa Escuret5, Cécile Moluçon-Chabrot4, Karine Augeul-Meunier3, Audrey Mirand6, Christel Regagnon6, Fabien Tinquaut7, Véronique Bousser7, Mathieu Oriol7, Denis Guyotat3, Gilles Salles8, Jacques-Olivier Bay5, Bruno Pozzetto2, Jérôme Cornillon3. 1. Hematology Department, Institut de Cancérologie Lucien Neuwirth, 108, bis avenue Albert Raymond, 42270 Saint-Priest-en-Jarez, France; Hematology Department, Hospices Civils de Lyon, Pavillon Marcel Bérard, Centre Hospitalier Lyon Sud, 165 chemin du Grand Revoyet, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite, France. Electronic address: marie.balsat@chu-lyon.fr. 2. CHU de Saint-Etienne, Laboratory of Infectious Agents and Hygiene, avenue Albert Raymond, 42270 Saint-Priest-en-jarez, France. 3. Hematology Department, Institut de Cancérologie Lucien Neuwirth, 108, bis avenue Albert Raymond, 42270 Saint-Priest-en-Jarez, France. 4. Hematology Department, CHU Clermont-Ferrand, 1, rue Lucie Aubrac, 63100 Clermont-Ferrand, France. 5. Hospices Civils de Lyon, GHN, Laboratoire de Virologie F-69317, Lyon, France. 6. CHU Clermont-Ferrand, Laboratory of Virology, F-63003 Clermont-Ferrand, France. 7. Institut de Cancérologie Lucien Neuwirth, Centre Hygée, Chemin de la Marandière, 42270 Saint-Priest-en-Jarez, France. 8. Hematology Department, Hospices Civils de Lyon, Pavillon Marcel Bérard, Centre Hospitalier Lyon Sud, 165 chemin du Grand Revoyet, Centre Hospitalier Lyon Sud, 69495 Pierre Bénite, France.
Abstract
OBJECTIVES: to prospectively evaluate the incidence and the clinical relevance on hematopoietic reconstitution of HHV-6 infection in autologous hematopoietic stem cell transplantation (ASCT) recipients. METHODS: HHV-6 DNA load was measured in whole blood specimens once during the 7 days before stem cell re-infusion and once a week after transplantation until hematopoietic recovery. Active HHV-6 infection was defined by 2 consecutive positive DNA loads. RESULTS: from July 2012 to February 2015, 196 adult patients undergoing ASCT were enrolled. Twenty-two (11.2%) patients developed active HHV-6 infection with a cumulative incidence of 19% at 40 days after transplantation. The onset of active HHV-6 infection occurred with a median of 13 days after stem cell re-infusion. HHV-6 infection was associated with an increased frequency of non-infectious complications (OR = 5.05; 95%CI 1.78-14.32; P < 0.001). Moreover, the severity of these non-infectious complications was higher in recipients exhibiting HHV-6 infection (OR = 4.62; 95%CI 1.32-16.2; p < 0.01). Delayed neutrophils 10 (IQR: 8-14) vs 8 (IQR: 6-11) days and platelets recoveries 15 (IQR: 11.8-18.5) vs 8 (IQR: 4-14) days were observed in patients with active HHV-6 infection compared to non-infected ones. CONCLUSIONS: in this study, 11.2% ASCT recipients presented active HHV-6 infection associated with significantly delayed hematologic reconstitution.
OBJECTIVES: to prospectively evaluate the incidence and the clinical relevance on hematopoietic reconstitution of HHV-6 infection in autologous hematopoietic stem cell transplantation (ASCT) recipients. METHODS:HHV-6 DNA load was measured in whole blood specimens once during the 7 days before stem cell re-infusion and once a week after transplantation until hematopoietic recovery. Active HHV-6 infection was defined by 2 consecutive positive DNA loads. RESULTS: from July 2012 to February 2015, 196 adult patients undergoing ASCT were enrolled. Twenty-two (11.2%) patients developed active HHV-6 infection with a cumulative incidence of 19% at 40 days after transplantation. The onset of active HHV-6 infection occurred with a median of 13 days after stem cell re-infusion. HHV-6 infection was associated with an increased frequency of non-infectious complications (OR = 5.05; 95%CI 1.78-14.32; P < 0.001). Moreover, the severity of these non-infectious complications was higher in recipients exhibiting HHV-6 infection (OR = 4.62; 95%CI 1.32-16.2; p < 0.01). Delayed neutrophils 10 (IQR: 8-14) vs 8 (IQR: 6-11) days and platelets recoveries 15 (IQR: 11.8-18.5) vs 8 (IQR: 4-14) days were observed in patients with active HHV-6 infection compared to non-infected ones. CONCLUSIONS: in this study, 11.2% ASCT recipients presented active HHV-6 infection associated with significantly delayed hematologic reconstitution.
Authors: Maximilian Christopeit; Martin Schmidt-Hieber; Rosanne Sprute; Oliver A Cornely; Georg Maschmeyer; Dieter Buchheidt; Marcus Hentrich; Meinolf Karthaus; Olaf Penack; Markus Ruhnke; Florian Weissinger Journal: Ann Hematol Date: 2020-10-20 Impact factor: 3.673