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Generation of Multivirus-specific T Cells to Prevent/treat Viral Infections after Allogeneic Hematopoietic Stem Cell Transplant
Published on: May 27, 2011
CMV Reactivation Following Allogeneic Transplantation in Children From a High-Seroprevalence Population: A
Andres Arias1, Natalia Builes2, Laura Niño-Serna3
1Hospital Universitario Erasmo Meoz, Cúcuta, Colombia.
Insights
Cytomegalovirus (CMV) reactivation in children after hematopoietic stem cell transplant (HSCT) occurred in 28% of cases. CMV reactivation did not negatively impact overall survival in this pediatric HSCT cohort.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Transplant Immunology
Background:
- Cytomegalovirus (CMV) infection is a common complication in pediatric hematopoietic stem cell transplant (HSCT) recipients.
- Data on CMV reactivation in children in developing countries is limited, especially with the rise of haploidentical HSCT using post-transplant cyclophosphamide (PTCy).
Purpose of the Study:
- To investigate the incidence, clinical features, and outcomes of CMV reactivation in children post-HSCT.
- To evaluate the impact of unmanipulated stem cells with PTCy for GvHD prophylaxis on CMV reactivation.
Main Methods:
- Retrospective cohort study of 166 children undergoing HSCT between January 2012 and June 2022.
- Analysis included baseline characteristics, clinical course, treatment duration, viral load, and time to DNAemia clearance.
- Survival analysis utilized Kaplan-Meier and log-rank tests.
Main Results:
- The cumulative incidence of CMV DNAemia was 28% at 100 days post-HSCT.
- No significant differences in CMV reactivation rates or outcomes were observed across different donor types.
- One-year overall survival was 60%, with CMV reactivation not adversely affecting survival.
Conclusions:
- CMV reactivation rates, treatment duration, viral clearance, co-infections, and survival were similar across various HSCT donor types.
- Further research is needed to refine monitoring criteria for CMV in pediatric HSCT recipients, particularly in regions adopting PTCy-based GvHD prophylaxis.
Introduction:
Cytomegalovirus (CMV) infection is a frequent complication among hematopoietic stem cell transplant (HSCT) recipients. Data regarding CMV reactivation in children in underdeveloped countries is scarce. This is especially notable considering the increasing utilization of haploidentical-related HSCT with the post-transplant cyclophosphamide platform. This study aimed to describe the incidence, clinical characteristics, and evolution of children with CMV reactivation after HSCT and the possible impact of unmanipulated stem cells with PTCy for GvHD prophylaxis.
Methods:
Retrospective cohort study of children undergoing hematopoietic stem cell transplantation from January 2012 to June 2022. Baseline characteristics and the clinical course were described. Duration of treatment, initial viral load, and time to clearance of DNAemia by type of transplant were compared using the Kruskal-Wallis test. Survival analysis was performed with the Kaplan-Meier method and log-rank test. All statistical analysis was performed using SPSS software, version 20.0.
Results:
One hundred sixty-six children were included. Among them, 87% of recipients and 88% of donors were CMV positive. The cumulative incidence of cytomegalovirus DNAemia was 28% at 100 days post-transplantation. There were no differences between different donor types. Overall survival at 1 year was 60%, and non-relapse mortality was observed in 28%. CMV reactivation did not appear to negatively impact 1-year overall survival (OS).
Conclusions:
Our study found no differences in CMV reactivation rates, treatment duration, viral clearance times, co-infections, or 1-year overall survival across different HSCT donor types. Studies are needed to establish more precise criteria for monitoring recipients, particularly in regions where unmanipulated stem cells with PTCy for GvHD prophylaxis are increasing.
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