CMV-IgG pre-allogeneic hematopoietic stem cell transplantation and the risk for CMV reactivation and mortality

被引:15
作者
Eberhardt, Kirsten Alexandra [1 ,2 ,3 ]
Jung, Verena [4 ,5 ,6 ]
Knops, Elena [7 ]
Heger, Eva [7 ]
Wirtz, Maike [7 ]
Steger, Gertrud [7 ]
Kaiser, Rolf [7 ]
Affeldt, Patrick [6 ,8 ,9 ]
Holtick, Udo [5 ,6 ]
Klein, Florian [7 ]
Scheid, Christof [5 ,6 ]
Di Cristanziano, Veronica [7 ]
机构
[1] Inst Hyg & Environm, Div Hyg & Infect Dis, Hamburg, Germany
[2] Univ Med Ctr Hamburg Eppendorf, Bernhard Nocht Inst Trop Med &1, Dept Trop Med, Hamburg, Germany
[3] Univ Med Ctr Hamburg Eppendorf, Dept Med 1, Hamburg, Germany
[4] Univ Hosp Essen, Dept Hematol & Stem Cell Transplantat, Essen, Germany
[5] Univ Hosp Cologne, Univ Cologne, Fac Med, Dept Internal Med 1, Cologne, Germany
[6] Univ Hosp Cologne, Univ Cologne, Cologne, Germany
[7] Univ Hosp Cologne, Univ Cologne, Inst Virol, Fac Med, Cologne, Germany
[8] Univ Cologne, Dept Internal Med 2, Fac Med, Cologne, Germany
[9] Univ Cologne, Ctr Mol Med Cologn, Fac Med, Cologne, Germany
关键词
CYTOMEGALOVIRUS SEROSTATUS; VIRAL LOAD; DONOR; DISEASE; IMPACT; ERA; RECIPIENT; PROPHYLAXIS; INFECTION; BLOOD;
D O I
10.1038/s41409-023-01944-2
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Cytomegalovirus (CMV) represents one of the most common infectious complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Currently, a common diagnostic test used to stratify the risk for CMV infection in allo-HSCT recipients is the qualitative CMV serology of donor and recipient. A positive serostatus of the recipient is the most important risk factor for CMV reactivation and associated with reduced overall survival post-transplantation (TX). Direct and indirect effects of CMV are involved in the poorer survival outcome. The present study investigated if the quantitative interpretation of anti-CMV IgG before allo-HSCT might serve as a novel parameter for the identification of patients at risk for CMV reactivation and worse outcome post-TX. For this purpose, a cohort of 440 allo-HSCT recipients over a period of 10 years was retrospectively analyzed. Our findings indicated that patients with high CMV IgG pre-allo-HSCT had a higher risk to develop CMV reactivation, including clinically relevant infections, and a worse prognosis 36 months post-allo-HSCT as compared to recipients with low CMV IgG values. In the letermovir (LMV) era, this group of patients might benefit from a closer CMV monitoring, and hence, earlier intervention if needed, especially after discontinuation of prophylaxis.
引用
收藏
页码:639 / 646
页数:8
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