Yeon Joo Lee1,2, Yiqi Su1, Christina Cho2,3, Roni Tamari2,3, Miguel-Angel Perales2,3, Ann A Jakubowski2,3, Genovefa A Papanicolaou1,2. 1. Infectious Diseases Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA. 2. Weill Cornell Medical College, New York, New York, USA. 3. Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Abstract
BACKGROUND: We examined the correlation between persistent human herpesvirus 6 (HHV-6) DNAemia (p-HHV-6) and absolute lymphocyte count (ALC), platelet count (PLT), and all-cause mortality by 1 year after ex vivo T-cell-depleted (TCD) hematopoietic cell transplant (HCT). METHODS: We analyzed a cohort of adult TCD HCT recipients during 2012-2016 prospectively monitored for plasma HHV-6 by quantitative polymerase chain reaction from day +14 post-HCT through day +100 (D+100). p-HHV-6 was defined as ≥2 consecutive values of ≥500 copies/mL by D+100. PLT and ALC were compared between patients with and without p-HHV-6 using generalized estimating equations (GEE). Multivariable Cox proportional hazard models (PH) were used to identify the impact of p-HHV-6 on 1 year mortality. RESULTS: Of 312 patients, 83 (27%) had p-HHV-6 by D+100. p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. In multivariable models, p-HHV-6 was associated with higher mortality by 1 year post-HCT (adjusted hazard ratio, 2.97 [95% confidence interval, 1.62-5.47]; P = .0005), after adjusting for age, antiviral treatment, and ALC at D+100. CONCLUSIONS: p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. p-HHV-6 was an independent predictor of mortality in the first year after TCD HCT.
BACKGROUND: We examined the correlation between persistent human herpesvirus 6 (HHV-6) DNAemia (p-HHV-6) and absolute lymphocyte count (ALC), platelet count (PLT), and all-cause mortality by 1 year after ex vivo T-cell-depleted (TCD) hematopoietic cell transplant (HCT). METHODS: We analyzed a cohort of adult TCD HCT recipients during 2012-2016 prospectively monitored for plasma HHV-6 by quantitative polymerase chain reaction from day +14 post-HCT through day +100 (D+100). p-HHV-6 was defined as ≥2 consecutive values of ≥500 copies/mL by D+100. PLT and ALC were compared between patients with and without p-HHV-6 using generalized estimating equations (GEE). Multivariable Cox proportional hazard models (PH) were used to identify the impact of p-HHV-6 on 1 year mortality. RESULTS: Of 312 patients, 83 (27%) had p-HHV-6 by D+100. p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. In multivariable models, p-HHV-6 was associated with higher mortality by 1 year post-HCT (adjusted hazard ratio, 2.97 [95% confidence interval, 1.62-5.47]; P = .0005), after adjusting for age, antiviral treatment, and ALC at D+100. CONCLUSIONS: p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. p-HHV-6 was an independent predictor of mortality in the first year after TCD HCT.
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