Dixie Huntley1, Estela Giménez1, María Jesús Pascual2, Juan Carlos Hernández-Boluda3, Beatriz Gago2, Lourdes Vázquez4, José Luis Piñana3, Magdalena García4, Ariadna Pérez3, David Serrano5, Marta Hernández5, Eliseo Albert1, Carlos Solano3,6, David Navarro1,7. 1. Microbiology Service, Hospital Clínico Universitario, INCLIVA ResearchInstitute, Valencia, Spain. 2. Hematology Service, Hospital Regional Universitario, Málaga, Spain. 3. Hematology Service, Hospital Clínico Universitario, INCLIVA ResearchInstitute, Valencia, Spain. 4. Hematology Service, Hospital Clínico Universitario, Salamanca, Spain. 5. Hematology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 6. Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain. 7. Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain.
Abstract
BACKGROUND: Conflicting data have been published as to the risk of cytomegalovirus (CMV) DNAemia and CMV disease in patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide. METHODS: We conducted a multicenter retrospective study including 118 patients subjected to unmanipulated haplo-HSCT to further clarify this issue. An historic cohort comprising 165 patients undergoing other transplant modalities (HLA-matched related, matched unrelated or mismatched) was built for comparison purposes. Plasma CMV DNA monitoring was performed using two highly sensitive real-time PCR assays. RESULTS: Overall, the cumulative incidence of CMV DNAemia, recurrent CMV DNAemia, and CMV DNAemia requiring preemptive antiviral therapy in patients undergoing haplo-HSCT was 63.9%, 34.9%, and 50.1%, respectively. These figures were rather comparable for other transplant modalities (P = .22, P = .13 and P = .72, respectively). A trend toward longer duration of episodes and shorter CMV DNA doubling times was observed in haplo-HSCT patients in comparison with other transplant modalities. Furthermore, median CMV DNA peak load was significantly higher in haplo-HSCTs (P = .008), yet overall mortality by day 180 and 365 was the same across comparison groups. There were five cases of CMV disease, and all occurred in haplo-HSCT patients. This latter observation is worrying and merits further investigation. CONCLUSIONS: The incidence of initial and recurrent episodes of CMV DNAemia either requiring or not antiviral therapy in unmanipulated haplo-HSCT was comparable to other transplant modalities in our cohort.
BACKGROUND: Conflicting data have been published as to the risk of cytomegalovirus (CMV) DNAemia and CMV disease in patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with post-transplantation cyclophosphamide. METHODS: We conducted a multicenter retrospective study including 118 patients subjected to unmanipulated haplo-HSCT to further clarify this issue. An historic cohort comprising 165 patients undergoing other transplant modalities (HLA-matched related, matched unrelated or mismatched) was built for comparison purposes. Plasma CMV DNA monitoring was performed using two highly sensitive real-time PCR assays. RESULTS: Overall, the cumulative incidence of CMV DNAemia, recurrent CMV DNAemia, and CMV DNAemia requiring preemptive antiviral therapy in patients undergoing haplo-HSCT was 63.9%, 34.9%, and 50.1%, respectively. These figures were rather comparable for other transplant modalities (P = .22, P = .13 and P = .72, respectively). A trend toward longer duration of episodes and shorter CMV DNA doubling times was observed in haplo-HSCT patients in comparison with other transplant modalities. Furthermore, median CMV DNA peak load was significantly higher in haplo-HSCTs (P = .008), yet overall mortality by day 180 and 365 was the same across comparison groups. There were five cases of CMV disease, and all occurred in haplo-HSCT patients. This latter observation is worrying and merits further investigation. CONCLUSIONS: The incidence of initial and recurrent episodes of CMV DNAemia either requiring or not antiviral therapy in unmanipulated haplo-HSCT was comparable to other transplant modalities in our cohort.
Authors: Dixie Huntley; Estela Giménez; María Jesús Pascual; María José Remigia; Paula Amat; Lourdes Vázquez; Marta Hernández; Juan Carlos Hernández-Boluda; Beatriz Gago; José Luis Piñana; Magdalena García; Ariadna Martínez; Eva Mateo; Roberto Gozalbo-Rovira; Eliseo Albert; Carlos Solano; David Navarro Journal: Bone Marrow Transplant Date: 2020-03-23 Impact factor: 5.483
Authors: Rafael Hernani; José Luis Piñana; Ariadna Pérez; Abdiel Quintero; Juan Montoro; Juan C Hernández-Boluda; Carlos Carretero; Aitana Balaguer-Roselló; Manuel Guerreiro; Ignacio Lorenzo; Cristóbal Aguilar; Estela Giménez; David Navarro; Miguel A Sanz; Jaime Sanz; Carlos Solano Journal: EJHaem Date: 2021-03-18
Authors: Elizabeth R Duke; Brian D Williamson; Bhavesh Borate; Jonathan L Golob; Chiara Wychera; Terry Stevens-Ayers; Meei-Li Huang; Nicole Cossrow; Hong Wan; T Christopher Mast; Morgan A Marks; Mary E Flowers; Keith R Jerome; Lawrence Corey; Peter B Gilbert; Joshua T Schiffer; Michael Boeckh Journal: J Clin Invest Date: 2021-01-04 Impact factor: 14.808
Authors: Andrew Lin; Jessica Flynn; Lauren DeRespiris; Bradley Figgins; Meagan Griffin; Carmen Lau; Anthony Proli; Sean M Devlin; Christina Cho; Roni Tamari; Ann A Jakubowski; Esperanza B Papadopoulos; Sergio A Giralt; Miguel-Angel Perales; Susan K Seo; Brian Shaffer Journal: Transplant Cell Ther Date: 2020-10-11