Early cytomegalovirus reactivation remains associated with increased transplant-related mortality in the current era: a CIBMTR analysis

Abstract

Key Points Cytomegalovirus after bone marrow transplantation remains associated with lower survival but not prevention of leukemia relapse.

Cytomegalovirus replication reduces the relapse incidence in patients with acute myeloid leukemia

“…This weakness in the study design seriously questions the reliability of the results of this study. 1 In contrast, we and others have published that CMV reactivation correlates with substantially improved reduction of relapse incidence in patients with AML after transplant. [2][3][4][5][6][7][8][9][10] The antileukemic effect of CMV reactivation is pronounced in AML and chronic myeloid leukemia (CML), but is detectable to a lesser extent in myelodysplastic syndrome (MDS), acute lymphoblastic leukemia (ALL), non-Hodgkin lymphoma, and pediatric acute leukemia.…”

“…Teira et al, Green et al, and Takenaka et al found that CMV reactivation was associated with an increased NRM rate. 1,3,4 Moreover, Takenaka et al and Teira et al reported that the OS rate was decreased. 1,4 In contrast, Jang et al as well as our group found that, in single-center studies, CMV reactivation was associated with an improved OS rate.…”

“…1,3,4 Moreover, Takenaka et al and Teira et al reported that the OS rate was decreased. 1,4 In contrast, Jang et al as well as our group found that, in single-center studies, CMV reactivation was associated with an improved OS rate. 9 Green et al observed a reduced risk of relapse by day 100 among patients with AML after transplant, but not in patients with ALL, lymphoma, CML, and MDS, whereas at 1 year after transplant CMV reactivation was associated with reduced risk of relapse in all patients but without achieving statistical significance.…”

Herpesvirus infection following allogenic hematopoietic stem cell transplantation with TCRaβ and CD19 depletion: risk factors and outcome

“…Опреде-лены наиболее значимые факторы риска ЦМВ-ин-фекции/болезни: серологический статус донора/ реципиента, развитие реакции «трансплантат против хозяина», использование различных типов антилим-фоцитарных антител, Т-клеточная деплеция ex vivo, трансплантация от неродственного или не полностью совместимого донора [6,[11][12][13][14]. Несмотря на то, что в большинстве исследований развитие ЦМВ-инфекции после ТГСК -это прогностически неблагоприятный фактор в отношении выживаемости, в ряде современ-ных работ показана возможная роль ЦМВ в протекции против рецидива лейкоза [15][16][17][18][19].…”

Coinfection with Human Cytomegalovirus Genetic Variants in Transplant Recipients and Its Impact on Antiviral T Cell Immune Reconstitution

“…However, CMV is a leading cause of viral complications in immunocompromised individuals (2). This is particularly evident in the absence of CMV-specific immunological memory, including in CMV-seropositive HSCT recipients (R ϩ ) who receive a transplant from a seronegative donor (D Ϫ ) and are at a higher risk of CMV reactivations and associated complications, including enterocolitis and pneumonitis (3)(4)(5). Current therapeutic strategies to control CMV reactivation in HSCT recipients predominantly involve the preemptive administration of ganciclovir to control CMV following detection of viral reactivation (6).…”