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Microbial Issues

CMV reactivation is associated with a lower incidence of relapse after allo-SCT for CML

Abstract

Preemptive therapy at CMV reactivation has diminished post-transplant CMV mortality. Furthermore, recent studies suggest a favorable ‘virus-versus-leukemia’ effect from reactivating CMV, reducing relapse of AML after SCT. We studied the relationship of CMV reactivation with leukemic relapse in 110 patients with CML receiving HLA-identical sibling SCT between 1993 and 2008. Of these, 79 (72%) were in chronic phase, 5 in second chronic phase, 17 in accelerated phase and 9 in blast phase. A total of 97 patients (88%) received a myeloablative conditioning regimen, 97 received 4-log ex vivo T cell-depleted grafts and 13 received T-replete grafts. CMV reactivation before day 100 was observed in 72 patients (65.5%). At a median follow-up of 6.2 years, CMV reactivation < day 100 as a time-dependent covariate was an independent factor associated with decreased relapse. We conclude that CMV reactivation may contribute to a beneficial GVL effect in CML transplant recipients.

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Acknowledgements

This research was supported by the Intramural Research Program of the National institutes of Health, at the National Heart, Lung, and Blood Institute.

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Correspondence to S Ito.

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Ito, S., Pophali, P., CO, W. et al. CMV reactivation is associated with a lower incidence of relapse after allo-SCT for CML. Bone Marrow Transplant 48, 1313–1316 (2013). https://doi.org/10.1038/bmt.2013.49

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