Cytomegalovirus (CMV) infections in children undergoing hematopoetic stem cell transplantation

Area of Science:

• Hematology
• Infectious Diseases
• Transplantation Immunology

Background:

• Cytomegalovirus (CMV) infection poses a major threat to patient outcomes following hematopoetic stem cell transplantation (HSCT).
• Understanding risk factors is crucial for preventing CMV disease and improving survival rates in pediatric HSCT recipients.

Purpose of the Study:

• To identify and analyze the risk factors associated with Cytomegalovirus (CMV) disease development in pediatric patients undergoing HSCT.

Main Methods:

• Retrospective analysis of 110 pediatric patients who underwent HSCT.
• Monitoring for CMV antigenemia (CMV infection in white blood cells).
• Evaluation of CMV serological status (donor and recipient), transplant type, graft-versus-host disease (GvHD), and timing of CMV infection.

Main Results:

• CMV antigenemia was diagnosed in 14.5% (16/110) of pediatric HSCT patients.
• Most CMV infections occurred after allogeneic HSCT (alloHSCT), with one case post-autologous HSCT.
• Risk factors identified include the type of transplant, pre-transplant CMV seropositivity in the recipient, and the presence/intensity of GvHD.
• CMV reactivation was the primary mode of infection, occurring early post-transplant in most cases, but late-onset infections and second reactivations were also observed.

Conclusions:

• CMV infection remains a significant complication post-pediatric HSCT.
• Transplant type, recipient serostatus, and GvHD are critical risk factors for CMV disease.
• CMV reactivation is common, and infection can manifest even in the late post-transplant period, including after autologous HSCT.