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Clinical outcomes of allogeneic hematopoietic stem cell transplant recipients developing Cytomegalovirus DNAemia prior to engraftment

Bone Marrow Transplantation volume 56, pages 1281–1290 (2021)Cite this article

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Abstract

There is limited information on the impact of CMV DNAemia episodes developing prior to engraftment (pre-CMV DNAemia) on clinical outcomes following allogeneic hematopoietic stem cell transplantation (allo-HSCT). This issue was addressed in the current retrospective multicenter study including 878 patients. All participant centers used preemptive antiviral therapy strategies for prevention of CMV disease. CMV DNA load in blood was monitored by real-time PCR assays. A total of 144 patients (cumulative incidence 16.5%, 95% CI, 14%–19%) had an episode of pre-CMV DNAemia at a median of 10 days after allo-HSCT. Patients who developed pre-CMV DNAemia had a significantly higher (P = < 0.001) probability of recurrent episodes (50%) than those who experienced post-CMV DNAemia (32.9%); Nevertheless, the incidence of CMV disease was comparable (P = 0.52). Cumulative incidences of overall mortality (OM) and non-relapse mortality (NRM) at 1-year after allo-HSCT were 32% (95% CI, 29–35%) and 23% (95% CI 20–26%), respectively. The risk of OM and NRM in adjusted models appeared comparable in patients developing a single episode of CMV DNAemia, regardless of whether it occurred before or after engraftment, in patients with pre- and post-engraftment CMV DNAemia episodes or in those without CMV DNAemia.

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Fig. 1: Time to detection of pre-engraftmet CMV DNAemia.

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Acknowledgements

Estela Giménez holds a Juan Rodés research contract from the Carlos III Health Institute (Ref. JR18/00053). Eliseo Albert holds a Río Hortega research contract from the Carlos III Health Institute (Ref. CM18/00221).

Funding

We thank Merck Sharp & Domme Spain (MSD) for providing the online platform for data registration. This work was funded by MSD through the Investigator Initiated Studies Program.

Author information

Authors and Affiliations

  1. Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain

    Carlos Solano & Ariadna Pérez

  2. Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain

    Carlos Solano

  3. Hematology Department, Complejo Asistencial Universitario de Salamanca-IBSAL, Salamanca, Spain

    Lourdes Vázquez

  4. Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain

    Estela Giménez, Eliseo Albert & David Navarro

  5. Hematology Department, Hospital de la Princesa, Madrid, Spain

    Rafael de la Cámara

  6. Hematology Department, Hospital Clinic Institute of Hematology & Oncology, Barcelona, Spain

    Montserrat Rovira & María Suárez-Lledó

  7. Hematology Department, Hospital Virgen del Rocío, Sevilla, Spain

    Ildefonso Espigado

  8. Hematology Department, Hospital Universitario Reina Sofía, Córdoba, Spain

    Carmen Martín Calvo

  9. Hematology Department, Hospital Ramón y Cajal, Madrid, Spain

    Javier López-Jiménez & Anabella Chinea

  10. Hematology Department, Hospital Sant Creu i Sant Pau, Barcelona, Spain

    Albert Esquirol

  11. Department of Hematology, Hospital Marques de Valdecilla, Santander, Spain

    Aránzazu Bermúdez

  12. Hematology Department, Hospital Universitario de Jerez, Cádiz, Spain

    Raquel Saldaña

  13. Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonación, IMIB, Universidad de Murcia, Murcia, Spain

    Inmaculada Heras

  14. Hematology-Stem cell Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo IISPA. IUOPA, Oviedo, Spain

    Ana Julia González-Huerta

  15. Hematology Department, Complejo Hospitalario Universitario, Vigo, Spain

    Tamara Torrado

  16. Hematology Department, Hospital Germans Trias i Pujol, Barcelona, Spain

    Montserrat Batlle

  17. Hematology Department, Hospital Universitario Doctor Negrín de Gran Canaria, Las Palmas, Spain

    Santiago Jiménez

  18. Hematology Department Hospital Universitario Donostia-Aránzazu, San Sebastián, Spain

    Carlos Vallejo

  19. Hematology Department Hospital Universitario Vall de Hebrón, Barcelona, Spain

    Pere Barba

  20. Hematology Department, Hospital Regional Universitario, Málaga, Spain

    María Ángeles Cuesta

  21. Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain, CIBERONC, Instituto Carlos III, Madrid, Spain

    José Luis Piñana

  22. Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain

    David Navarro

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  1. Carlos Solano
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  2. Lourdes Vázquez
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  18. Tamara Torrado
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  19. Montserrat Batlle
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  20. Santiago Jiménez
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  21. Carlos Vallejo
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  24. José Luis Piñana
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  25. David Navarro
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Spanish Group of Hematopoietic Transplantation and Cell Therapy (GETH)

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Correspondence to David Navarro.

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Solano, C., Vázquez, L., Giménez, E. et al. Clinical outcomes of allogeneic hematopoietic stem cell transplant recipients developing Cytomegalovirus DNAemia prior to engraftment. Bone Marrow Transplant 56, 1281–1290 (2021). https://doi.org/10.1038/s41409-020-01157-x

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