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Comparison of different cytomegalovirus diseases following haploidentical hematopoietic stem cell transplantation.

Abstract：

:Cytomegalovirus (CMV) can cause end-organ diseases including pneumonia, gastroenteritis, retinitis, and encephalitis in hematopoietic stem cell transplantation recipients. Potential differences among different CMV diseases remain uncertain. This study aimed to compare the clinical characteristics, risk factors, and mortality among different CMV diseases. A retrospective nested case-control study was performed based on a cohort of 3862 patients who underwent haploidentical hematopoietic stem cell transplantation at a single-center. CMV diseases occurred in 113 (2.92%) of 3862 haplo-HSCT recipients, including probable CMV pneumonia (CMVP, n = 34), proven CMV gastroenteritis (CMVG, n = 34), CMV retinitis (CMVR, n = 31), probable CMV encephalitis (CMVE, n = 7), and disseminated CMV disease (Di-CMVD, n = 7). Most (91.2%) cases of CMVG developed within 100 days, while most (90.3%) cases of CMVR were late onset. Refractory CMV infection and CMV viral load at different levels were associated with an increased risk of CMVP, CMVG, and CMVR. Compared with patients without CMV diseases, significantly higher non-relapse mortality at 1 year after transplantation was observed in patients with CMVP and CMVR, rather than CMVG. Patients with CMVP, Di-CMVD, and CMVE had higher overall mortality after diagnosis than that of patients with CMVG and CMVR (61.7%, 57.1%, 40.0% vs 27.7%, 18.6%, P = 0.001). In conclusion, the onset time, viral dynamics, and mortality differ among different CMV diseases. The mortality of CMV diseases remains high, especially for CMVP, Di-CMVD, and CMVE.

journal_name

Ann Hematol

journal_title

Annals of hematology

authors

Meng XY,Fu HX,Zhu XL,Wang JZ,Liu X,Yan CH,Zhang YY,Mo XD,Wang Y,Han W,Chen YH,Chen DB,Liu HX,Chang YJ,Xu LP,Liu KY,Huang XJ,Zhang XH

doi

10.1007/s00277-020-04201-4

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

2659-2670

issue

11

eissn

0939-5555

issn

1432-0584

pii

10.1007/s00277-020-04201-4

journal_volume

99

pub_type

临床试验,杂志文章

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