QuantiFERON‐cytomegalovirus to predict clinically significant cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation. Issue 2 (25th January 2022)

• Record Type: Journal Article
• Authors: Thompson, Grace; Boan, Peter; Purtill, Duncan; Cooney, Julian; Cannell, Paul; Wright, Matthew; John, Mina
• Is Part Of: Transplant infectious disease. Volume 24:Issue 2(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-01-25
• Subjects: bone marrow transplant -- cytomegalovirus -- interferon gamma release assay -- QuantiFERON -- stem cell transplant -- T‐cell immunity; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.13786
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: Controlling cytomegalovirus (CMV) infection through prophylaxis or pre‐emptive therapy remains an important contributor to outcomes after allogeneic hematopoetic stem cell transplant (alloHCT). Predicting clinically significant CMV infection (csCMVi) after day 100 remains a challenge. Methods: We examined the abilty of the QuantiFERON‐CMV assay (QFN‐CMV) at day 100 (d100) and day 150 (d150) after alloHCT to predict csCMVi after these time points, with median follow‐up of 3.1 years (range 1.3–4.3 years). Results: In 46 transplants (donor seropositive (D+) recipient seronegative (R‐) = 12, D+R+ = 25, D‐R+ = 9; matched related = 13, unrelated donor = 32, haploidentical = 1), for the prediction of freedom from csCMVi >d100, QFN‐CMVd100 (positive compared to negative/indeterminate) had sensitivity 62% (23/37), specificity 100% (9/9), positive predictive value 100% (23/23), and negative predictive value 39% (9/23). For the prediction of freedom from csCMVi >d150, QFN‐CMVd150 (positive compared to negative/indeterminate) had sensitivity 62% (18/29), specificity 83% (5/6), positive predictive value 95% (18/19), and negative predictive value 31% (5/16). Conclusion: Positive QFN‐CMV at d100 and d150 strongly predicted freedom from csCMVi after these time points. QFN‐CMV could be utilized to predict the need for pre‐emptive therapy and CMV viral load monitoring after day 100 post‐alloHCT.