Cytomegalovirus DNAemia and risk of mortality in allogeneic hematopoietic stem cell transplantation: Analysis from the Spanish Hematopoietic Transplantation and Cell Therapy Group
Por:
Solano, C, Vazquez, L, Gimenez, E, de la Camara, R, Albert, E, Rovira, M, Espigado, I, Calvo, CM, Lopez-Jimenez, J, Suarez-Lledo, M, Chinea, A, Esquirol, A, Perez, A, Bermudez, A, Saldana, R, Heras, I, Gonzalez-Huerta, AJ, Torrado, T, Bautista, G, Batlle, M, Jimenez, S, Vallejo, C, Barba, P, Cuesta, MA, Pinana, JL and Navarro, D
Publicada:
1 ene 2021
Ahead of Print:
1 jul 2020
Resumen:
The net impact of cytomegalovirus (CMV) DNAemia on overall mortality (OM) and nonrelapse mortality (NRM) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains a matter of debate. This was a retrospective, multicenter, noninterventional study finally including 749 patients. CMV DNA monitoring was conducted by real-time polymerase chain reaction (PCR) assays. Clinical outcomes of interest were OM and NRM through day 365 after allo-HSCT. The cumulative incidence of CMV DNAemia in this cohort was 52.6%. A total of 306 out of 382 patients with CMV DNAemia received preemptive antiviral therapy (PET). PET use for CMV DNAemia, but not the occurrence of CMV DNAemia, taken as a qualitative variable, was associated with increased OM and NRM in univariate but not in adjusted models. A subcohort analysis including patients monitored by the COBAS Ampliprep/COBAS Taqman CMV Test showed that OM and NRM were comparable in patients in whom either low or high plasma CMV DNA threshold (<500 vs >= 500 IU/mL) was used for PET initiation. In conclusion, CMV DNAemia was not associated with increased OM and NRM in allo-HSCT recipients. The potential impact of PET use on mortality was not proven but merits further research.
Filiaciones:
Solano, C:
Hosp Clin Univ, INCLIVA Res Inst, Hematol Dept, Valencia, Spain
Univ Valencia, Sch Med, Dept Med, Valencia, Spain
Vazquez, L:
Complejo Asistencial Univ Salamanca IBSAL, Hematol Dept, Salamanca, Spain
Gimenez, E:
Hosp Clin Univ, INCLIVA Res Inst, Microbiol Serv, Valencia, Spain
de la Camara, R:
Hosp Princesa, Hematol Dept, Madrid, Spain
Hosp Univ Reina Sofia, Hematol Dept, Cordoba, Spain
Albert, E:
Hosp Clin Univ, INCLIVA Res Inst, Microbiol Serv, Valencia, Spain
Rovira, M:
Hosp Clin Inst Hematol & Oncol, Hematol Dept, Barcelona, Spain
Espigado, I:
Hosp Virgen Rocio, Hematol Dept, Seville, Spain
Calvo, CM:
Hosp Univ Reina Sofia, Hematol Dept, Cordoba, Spain
Lopez-Jimenez, J:
Hosp Ramon & Cajal, Hematol Dept, Madrid, Spain
Suarez-Lledo, M:
Hosp Clin Inst Hematol & Oncol, Hematol Dept, Barcelona, Spain
Chinea, A:
Hosp Ramon & Cajal, Hematol Dept, Madrid, Spain
Esquirol, A:
Hosp Sant Creu & Sant Pau, Hematol Dept, Barcelona, Spain
Perez, A:
Hosp Clin Univ, INCLIVA Res Inst, Hematol Dept, Valencia, Spain
Bermudez, A:
Hosp Marques Valdecilla, Dept Hematol, Santander, Spain
Saldana, R:
Hosp Univ Jerez, Hematol Dept, Cadiz, Spain
Heras, I:
Univ Murcia, Hosp Univ Morales Meseguer, Hematol Dept, Murcia, Spain
Univ Murcia, Ctr Reg Hemodonac, IMIB, Murcia, Spain
Gonzalez-Huerta, AJ:
Hosp Univ Cent Asturias, Hematol Stem Cell Transplantat Unit, Oviedo IISPA, IUOPA, Oviedo, Spain
Torrado, T:
Complejo Hosp Univ, Hematol Dept, Vigo, Spain
Bautista, G:
Hosp Univ Puerta Hierro, Hematol Dept, Madrid, Spain
:
Hosp Badalona Germans Trias & Pujol, Hematol Dept, Barcelona, Spain
Jimenez, S:
Hosp Univ Doctor Negrin Gran Canaria, Hematol Dept, Las Palmas Gran Canaria, Spain
Vallejo, C:
Hosp Univ Donostia Aranzazu, Hematol Dept, San Sebastian, Spain
Barba, P:
Univ Vall Hebron, Hematol Dept Hosp, Barcelona, Spain
Cuesta, MA:
Hosp Reg Univ, Hematol Dept, Malaga, Spain
Pinana, JL:
Hosp Univ & Politecn La Fe, Hematol Dept, Valencia, Spain
Inst Carlos III, CIBERONC, Madrid, Spain
Navarro, D:
Hosp Clin Univ, INCLIVA Res Inst, Microbiol Serv, Valencia, Spain
Univ Valencia, Sch Med, Dept Microbiol, Valencia, Spain
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