TY - JOUR
T1 - Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era
T2 - A CIBMTR analysis
AU - Teira, Pierre
AU - Battiwalla, Minoo
AU - Ramanathan, Muthalagu
AU - Barrett, A. John
AU - Ahn, Kwang Woo
AU - Chen, Min
AU - Green, Jaime S.
AU - Saad, Ayman
AU - Antin, Joseph H.
AU - Savani, Bipin N.
AU - Lazarus, Hillard M.
AU - Seftel, Matthew
AU - Saber, Wael
AU - Marks, David
AU - Aljurf, Mahmoud
AU - Norkin, Maxim
AU - Wingard, John R.
AU - Lindemans, Caroline A.
AU - Boeckh, Michael
AU - Riches, Marcie L.
AU - Auletta, Jeffery J.
N1 - Publisher Copyright:
© 2016, American Society of Hematology. All rights reserved.
PY - 2016/5/19
Y1 - 2016/5/19
N2 - Single-center studies have reported an association between early (before day 100) cytomegalovirus (CMV) reactivation and decreased incidence of relapse for acute myeloid leukemia (AML) following allogeneic hematopoietic cell transplantation. To substantiate these preliminary findings, the Center for International Blood and Marrow Transplant Research (CIBMTR) Database was interrogated to analyze the impact of CMV reactivation on hematologic disease relapse in the current era. Data from 9469 patients transplanted with bone marrow or peripheral blood between 2003 and 2010 were analyzed according to 4 disease categories: AML (n = 5310); acute lymphoblastic leukemia (ALL, n = 1883); chronic myeloid leukemia (CML, n = 1079); and myelodysplastic syndrome (MDS, n = 1197). Median time to initial CMV reactivation was 41 days (range, 1-362 days). CMV reactivation had no preventive effect on hematologic disease relapse irrespective of diagnosis. Moreover, CMV reactivation was associated with higher nonrelapse mortality [relative risk [RR] among disease categories ranged from 1.61 to 1.95 and P values from .0002 to <.0001; 95% confidence interval [CI], 1.14-2.61). As a result, CMV reactivation was associated with lower overall survival for AML (RR = 1.27; 95% CI, 1.17-1.38; P <.0001), ALL (RR = 1.46; 95% CI, 1.25-1.71; P <.0001), CML (RR = 1.49; 95% CI, 1.19-1.88; P = .0005), and MDS (RR = 1.31; 95% CI, 1.09-1.57; P = .003). In conclusion, CMV reactivation continues to remain a risk factor for poor posttransplant outcomes and does not seem to confer protection against hematologic disease relapse.
AB - Single-center studies have reported an association between early (before day 100) cytomegalovirus (CMV) reactivation and decreased incidence of relapse for acute myeloid leukemia (AML) following allogeneic hematopoietic cell transplantation. To substantiate these preliminary findings, the Center for International Blood and Marrow Transplant Research (CIBMTR) Database was interrogated to analyze the impact of CMV reactivation on hematologic disease relapse in the current era. Data from 9469 patients transplanted with bone marrow or peripheral blood between 2003 and 2010 were analyzed according to 4 disease categories: AML (n = 5310); acute lymphoblastic leukemia (ALL, n = 1883); chronic myeloid leukemia (CML, n = 1079); and myelodysplastic syndrome (MDS, n = 1197). Median time to initial CMV reactivation was 41 days (range, 1-362 days). CMV reactivation had no preventive effect on hematologic disease relapse irrespective of diagnosis. Moreover, CMV reactivation was associated with higher nonrelapse mortality [relative risk [RR] among disease categories ranged from 1.61 to 1.95 and P values from .0002 to <.0001; 95% confidence interval [CI], 1.14-2.61). As a result, CMV reactivation was associated with lower overall survival for AML (RR = 1.27; 95% CI, 1.17-1.38; P <.0001), ALL (RR = 1.46; 95% CI, 1.25-1.71; P <.0001), CML (RR = 1.49; 95% CI, 1.19-1.88; P = .0005), and MDS (RR = 1.31; 95% CI, 1.09-1.57; P = .003). In conclusion, CMV reactivation continues to remain a risk factor for poor posttransplant outcomes and does not seem to confer protection against hematologic disease relapse.
UR - http://www.scopus.com/inward/record.url?scp=84974571320&partnerID=8YFLogxK
U2 - 10.1182/blood-2015-11-679639
DO - 10.1182/blood-2015-11-679639
M3 - Article
C2 - 26884374
AN - SCOPUS:84974571320
SN - 0006-4971
VL - 127
SP - 2427
EP - 2438
JO - Blood
JF - Blood
IS - 20
ER -