Absence of early HHV‐6 reactivation after cord blood allograft predicts powerful graft‐versus‐tumor effect. Issue 8 (20th June 2018)

• Record Type: Journal Article
• Authors: Rashidi, Armin; Ebadi, Maryam; Said, Bassil; Cao, Qing; Shanley, Ryan; Curtsinger, Julie; Bejanyan, Nelli; Warlick, Erica D.; Green, Jaime S.; Brunstein, Claudio G.; Miller, Jeffrey S.; Weisdorf, Daniel J.
• Is Part Of: American journal of hematology. Volume 93:Issue 8(2018:Aug.)
• Page Start: 1014
• Page End: 1019
• Publication Date: 2018-06-20
• Subjects: Hematology -- Periodicals; 616.15
• DOI: 10.1002/ajh.25141
• Languages: English
• ISSNs: 0361-8609

Abstract

Abstract: Approximately 75% of cord blood transplant (CBT) recipients experience human herpes virus‐6 (HHV‐6) reactivation. Considering the immunomodulatory effects of HHV‐6, we hypothesized that early HHV‐6 reactivation may influence the risk of relapse of the underlying hematologic malignancy. In 152 CBT recipients with hematological malignancies, we determined the association between HHV‐6 reactivation by day +28 and 2‐year cumulative incidence of relapse. In univariate analysis, the absence of HHV‐6 reactivation ( n = 32) was associated with less relapse (26 [18‐35]% vs. 7 [0‐17]% in groups with vs. without HHV‐6 reactivation, respectively; P = .03). This difference was due to a remarkably low relapse incidence among patients without HHV‐6 reactivation. In multivariable analysis, the absence of HHV‐6 reactivation was associated with less relapse (hazard ratio [95% confidence interval]: 0.2 [0.05‐0.9], P = .03). This association was independent of patient‐, disease‐, and transplant‐related characteristics known to influence the risk of relapse. Natural killer cell and T‐cell reconstitution at day +28 were similar between patients with vs. without HHV‐6 reactivation. Our results suggest that CB allografts not complicated by HHV‐6 reactivation by day +28 have a powerful graft‐versus‐tumor effect. Knowledge about early HHV‐6 reactivation may stratify patients at day +28 into low vs. high relapse risk groups.