Risk factors and prognostic scale for cytomegalovirus (CMV) infection in CMV‐seropositive patients after allogeneic hematopoietic cell transplantation. Issue 4 (18th June 2015)

• Record Type: Journal Article
• Authors: Cohen, L.; Yeshurun, M.; Shpilberg, O.; Ram, R.
• Is Part Of: Transplant infectious disease. Volume 17:Issue 4(2015)
• Page Start: 510
• Page End: 517
• Publication Date: 2015-06-18
• Subjects: Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.12398
• Languages: English
• ISSNs: 1398-2273

Abstract

<abstract abstract-type="main" id="tid12398-abs-0001"> <title>Abstract</title> <sec id="tid12398-sec-0001" sec-type="section"> <title>Aim</title> <p>We aimed to study the risk factors for first and subsequent cytomegalovirus (CMV) infection among patients who are CMV seropositive and underwent allogeneic hematopoietic cell transplantation (HCT).</p> </sec> <sec id="tid12398-sec-0002" sec-type="section"> <title>Methods</title> <p>We performed an historical cohort study of all sequential CMV‐seropositive patients who underwent allogeneic HCT at a single center. Between May 2007 and December 2012, 121 patients fulfilled inclusion criteria.</p> </sec> <sec id="tid12398-sec-0003" sec-type="section"> <title>Results</title> <p>Multivariate model identified myeloablative preparative regimen (hazard ratio [HR] = 4.297, <italic>P</italic> = 0.033) and acute graft‐versus‐host disease (GVHD) prior to infection (HR = 5.091, <italic>P</italic> = 0.021) as risk factors for first CMV infection. The cumulative incidences of first CMV infection for patients with 0, 1, and 2 risk factors were 52%, 71%, and 91%, respectively. Multivariate analysis identified the diagnosis of lymphoma/myeloma (HR = 3.5, <italic>P</italic> = 0.049) and GVHD (HR = 1.280, <italic>P</italic> = 0.045) as risk factors for subsequent CMV infection. High graft CD3 stem cell dose was associated with a trend of lower rate of subsequent CMV infection (HR = 0.543, <italic>P</italic> = 0.056). The cumulative incidences for subsequent CMV infection in patients with 0, 1, and 2–3 risk factors were 11%, 41%, and 77%, respectively.</p> </sec> <sec id="tid12398-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In conclusion, in CMV‐seropositive patients, myeloablative conditioning and acute GVHD are risk factors for first CMV infection, while lymphoma/myeloma, ongoing GVHD, and low CD3 graft content are risk factors for subsequent infection.</p> </sec> </abstract>