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Microbial Issues

HHV-6 encephalitis in umbilical cord blood transplantation: a systematic review and meta-analysis

Bone Marrow Transplantation volume 48, pages 574–580 (2013)Cite this article

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Abstract

Reactivation of human herpesvirus-6 (HHV-6) frequently occurs following hematopoietic SCT (HSCT), and has been associated with clinical consequences in many patient populations. HHV-6 reactivation and HHV-6 encephalitis seem to occur more frequently in patients undergoing HSCT with cord blood (CB) as the stem cell source. We have conducted a systematic literature review and meta-analysis to investigate the clinical significance of this correlation. A systematic review of publications indexed in PubMed was performed for HSCT studies published over the past 10 years that fit inclusion criteria. Data on prevalences of HHV-6 reactivation and HHV-6 encephalitis post HSCT were abstracted from 19 papers. Meta-analyses were conducted to calculate combined prevalence estimates. The prevalences of HHV-6 reactivation and encephalitis were compared among CB vs non-CB HSCT. Prevalences of HHV-6 reactivation and HHV-6 encephalitis were significantly higher in patients receiving CB as the stem cell source than in patients receiving another stem cell source (72.0% vs 37.4%, P<0.0001; 8.3% vs 0.50%, P<0.0001, respectively). HHV-6 reactivation and HHV-6 encephalitis are significant complications in the post-HSCT setting, particularly in patients receiving CB as the stem cell source. Thus, patients undergoing umbilical CB transplantation should be closely monitored for HHV-6 reactivation.

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  1. M E Scheurer and J C Pritchett: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA

    M E Scheurer

  2. Dan L Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA

    M E Scheurer & E S Amirian

  3. HHV-6 Foundation, Santa Barbara, CA, USA

    J C Pritchett & N R Zemke

  4. Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD, USA

    P Lusso

  5. Division of Hematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden

    P Ljungman

  6. Department of Hematology, Karolinska University Hospital, Stockholm, Sweden

    P Ljungman

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Scheurer, M., Pritchett, J., Amirian, E. et al. HHV-6 encephalitis in umbilical cord blood transplantation: a systematic review and meta-analysis. Bone Marrow Transplant 48, 574–580 (2013). https://doi.org/10.1038/bmt.2012.180

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