Cytomegalovirus in Hematopoietic Stem Cell Transplant Recipients

Ljungman, Per; Hakki, Morgan; Boeckh, Michael

doi:10.1016/j.hoc.2010.11.011

Cited by 359 publications

(249 citation statements)

References 153 publications

Supporting

Mentioning

220

Contrasting

Unclassified

Order By: Relevance

“…CMV infection has long been recognised as an important cause of morbidity and mortality in recipients of allo-SCT. 27 However, previously published studies investigating allo-SCT in MM have not analysed the impact of CMV serostatus on outcome. [5][6][7][8][9][10][11]22,28,29 Primary infection or re-activation can occur in CMV-seropositive recipients and recipients of grafts from seropositive donors.…”

Section: Discussionmentioning

confidence: 99%

Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation

Auner

Szydlo

Biezen

et al. 2013

Bone Marrow Transplant

View full text Add to dashboard Cite

Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the treatment of relapse/progression after prior auto-SCT. Median age at RIC allo-SCT was 54.1 years, and 44.6% of patients had undergone two or more prior auto-SCTs. Median OS and PFS from the time of RIC allo-SCT for the entire population were 24.7 and 9.6 months, respectively. Cumulative non-relapse mortality (NRM) at 1 year was 21.5%. In multivariate analysis, CMV seronegativity of both patient and donor was associated with significantly better PFS, OS and NRM. Patient-donor gender mismatch was associated with better PFS, fewer than two prior auto-SCT was associated with better OS, and shorter time from the first auto-SCT to the RIC allo-SCT was associated with lower NRM. The results of this study identify patient and donor CMV seronegativity as the key prognostic factor for outcome after RIC allo-SCT for MM relapsing or progressing after prior auto-SCT.

show abstract

Section: Discussionmentioning

confidence: 99%

Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation

Auner

Szydlo

Biezen

et al. 2013

Bone Marrow Transplant

View full text Add to dashboard Cite

show abstract

“…Survival is always about 3-5% worse for CMV seropositive patients compared with CMV seronegative patients for low but not for very high-risk patients (risk score 5-7). 21,33 Hence, the additional influence of CMV serostatus becomes negligible in high-risk patients (Figure 4). In contrast, the role of Karnofsky performance score becomes increasingly important with increasing risk score ( Figure 5).…”

Section: Combination With Other Risk Factorsmentioning

confidence: 99%

The EBMT risk score

Gratwohl

2011

Bone Marrow Transplant

275

235

View full text Add to dashboard Cite

The European Group for Blood and Marrow Transplantation (EBMT) risk score provides a simple tool to assess instantly chances and risks of hematopoietic SCT(HSCT) for an individual patient pre-transplant. Five factors, age of the patient, stage of the disease, time from diagnosis, donor type and donor recipient gender combination augment risk for an individual patient with increasing score from 0 as best to 7 as worst in an additive way. The score holds for all acquired hematological disorders, for allogeneic and autologous HSCT (score 0-5), is independent of the HSCT technology and is valid for standard or reduced intensity conditioning. Survival is uniformly worse for older patients, transplanted in advanced disease stage after a long-time interval and with a mismatched donor than for younger patients, transplanted soon in early stage with a well matched donor. Additional risk factors such as performance score, CMV serostatus or cytokine polymorphisms improve prediction but to different extents for low or high-risk patients. Comparative assessment of disease risk and global pre-transplant risk should guide decisions for each patient with his/her specific disease between HSCT and a non-transplant approach and replace the traditional 'donor vs no donor' with such a risk-adapted individualized strategy.

show abstract

“…However, it still remains one of the major infectious complications and causes of morbidity and mortality after hematopoietic stem cell transplantation (HSCT) (Russell et al, 2011;Ljungman et al, 2011). Risk factors for CMV infection in HSCT patients include CMV seropositivity of donor and recipient, allogeneic transplantation (especially with T cell-depleted unrelated or HLA-mismatched donors) and cell source.…”

Section: Introductionmentioning

confidence: 99%