Cytomegalovirus DNA load monitoring in stool specimens for anticipating the occurrence of intestinal acute graft‐versus‐host disease following allogeneic hematopoietic stem cell transplantation: Is it of any value?. Issue 6 (16th August 2020)

• Record Type: Journal Article
• Authors: Bueno, Felipe; Albert, Eliseo; Giménez, Estela; Piñana, José Luis; Pérez, Ariadna; Gómez, María Dolores; Hernández‐Boluda, Juan Carlos; Gonzalez‐Barberá, Eva María; Montoro, Juan; Guerreiro, Manuel; Balaguer‐Roselló, Aitana; Hernani, Rafael; Sanz, Jaime; Solano, Carlos; Navarro, David
• Is Part Of: Transplant infectious disease. Volume 22:Issue 6(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-08-16
• Subjects: allogeneic hematopoietic stem cell transplantation -- Cytomegalovirus DNA -- intestinal aGvHD -- stool specimens; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.13440
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: Data have been published suggesting a bidirectional interaction between cytomegalovirus (CMV) infection and acute graft‐versus‐host disease (aGvHD) in allogeneic hematopoietic stem cell transplant (allo‐HSCT) recipients. Here, we hypothesized that prospective CMV DNA monitoring in stool specimens may be useful for predicting subsequent occurrence of intestinal aGvHD (IaGvHD). Methods: This two‐center study enrolled 121 consecutive adult patients undergoing any modality of allo‐HSCT. A total of 1, 009 stool specimens were collected (a median of 7 specimens/patient; range, 1‐18). CMV DNA monitoring in stools and plasma was performed using real‐time PCR assays. Results: CMV DNA was detected in stools in 20 patients (cumulative incidence, 16.9%; 95% CI, 6.3%‐31.8%). Median CMV DNA level in stool specimens was 1, 258 IU/0.1g (range, 210‐4, 087 IU/0.1 g). All these patients and their donors were CMV seropositive, and 16 of the 20 patients also had CMV DNAemia, while 4 patients had CMV DNA detected in stools without CMV DNAemia. No correlation was found between CMV DNA loads in plasma and stools ( P = .40). Prior CMV DNAemia, aGvHD, or IaGvHD were not associated with presence of CMV DNA in feces. IaGvHD was present in 30 patients, in 5 of whom CMV DNA was detected in stools. Neither detection of CMV DNA in feces nor in plasma was associated with subsequent IaGvHD (OR, 0.67; 95% CI, 0.18‐2.52; P = .55 and OR, 0.86; 95% CI, 0.38‐1.96 ; P = .71, respectively). No patient in this cohort had CMV end‐organ disease within the study period. Conclusion: Our study failed to provide evidence pointing to a reciprocal interaction between GI CMV infection and IaGvHD. CMV DNA monitoring in stools seems of no value to anticipate occurrence of IaGvHD.