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The patient’s CMV serological status affects clinical outcome after T-cell replete haplo-HSCT and post-transplant cyclophosphamide

Bone Marrow Transplantation volume 51, pages 1134–1136 (2016)Cite this article

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The role of a patient’s serostatus against CMV on the final outcome has to be yet specifically addressed in the setting of haploidentical hematopoietic stem cell transplantation using post-transplant high-dose cyclophosphamide (haplo-HSCT with PT-Cy). The issue is noteworthy since the reproducibility, the acceptable toxicity and the ease of finding a donor within the appropriate timing is conducting to an increasing use of haplo-HSCT with PT-Cy overall,1 even challenging the use of matched unrelated donors in particular situations.2, 3 CMV infection is known to be responsible for substantial morbidity and mortality following allogeneic transplantation;4, 5 most findings suggest that CMV serostatus significantly affects patient survival especially in situations of sustained immunosuppression (myeloablative conditioning, unrelated donor, use of T-cell depletion), whereas the same question is still open in the setting of haplo-HSCT with PT-Cy.

We here conducted a cohort study on a series of 207 consecutive adult patients receiving haplo-HSCT with PT-Cy for a hematological disease at two institutions (Institut Paoli-Calmettes, Marseille, France and Humanitas Clinical and Research Center, Rozzano, Italy) from September 2009 to April 2015. Data were collected as of 9th July 2015. Patients were grouped into four cohorts according to patient/donor CMV serostatus and followed up to the last contact. Administration of conditioning regimens and the choice of bone marrow (BM) or peripheral blood stem cells (PBSC) source followed internal policies, as previously reported;2, 6, 7 the choice of the haploidentical donor was based on general criteria that are also valid for HLA-identical sibling or unrelated donor selection with the only additional requirement of the absence of donor-specific antibodies. Whenever possible, a CMV-matched donor was chosen (particularly for CMV− patients).

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Acknowledgements

We thank all the involved physicians and nurses at the Humanitas Clinical and Research Center (Rozzano, Italy) and the Institut Paoli-Calmettes (Marseille, France) for providing excellent care for our patients and for their important study contributions and dedicated patient care.

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Authors and Affiliations

  1. Department of Oncology, Humanitas Clinical and Research Center, Rozzano, Italy

    R Crocchiolo, L Castagna, B Sarina, S Bramanti, L Morabito, A Rimondo, D Girardi, C Carlo-Stella & A Santoro

  2. Department of Hematology, Institut Paoli-Calmettes, Marseille, France

    S Furst, R Devillier, J El-Cheikh, A Granata, S Harbi, C Faucher, B Mohty, B Calmels, C Chabannon, R Bouabdallah, N Vey, P J Weiller & D Blaise

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  1. R Crocchiolo
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Correspondence to R Crocchiolo.

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Crocchiolo, R., Castagna, L., Furst, S. et al. The patient’s CMV serological status affects clinical outcome after T-cell replete haplo-HSCT and post-transplant cyclophosphamide. Bone Marrow Transplant 51, 1134–1136 (2016). https://doi.org/10.1038/bmt.2016.69

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