Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry

被引：20

作者：

Ljungman, Per ^{[1
,2
]}

Tridello, Gloria ^{[3
]}

Pinana, Jose Luis ^{[4
,5
]}

Ciceri, Fabio ^{[6
]}

Sengeloev, Henrik ^{[7
]}

Kulagin, Alexander ^{[8
]}

Mielke, Stephan ^{[1
,9
]}

Yegin, Zeynep Arzu ^{[10
]}

Collin, Matthew ^{[11
,12
]}

Einardottir, Sigrun ^{[13
,14
]}

Lepretre, Sophie Ducastelle ^{[15
]}

Maertens, Johan ^{[16
]}

Campos, Antonio ^{[17
]}

Metafuni, Elisabetta ^{[18
]}

Pichler, Herbert ^{[19
]}

Folber, Frantisek ^{[20
,21
]}

Solano, Carlos ^{[3
]}

Nicholson, Emma ^{[22
]}

Yuksel, Meltem Kurt ^{[23
]}

Carlson, Kristina ^{[24
]}

Aguado, Beatriz ^{[25
]}

Besley, Caroline ^{[26
]}

Byrne, Jenny ^{[27
]}

Heras, Immaculada ^{[28
]}

Dignan, Fiona ^{[29
]}

Kroger, Nicolaus ^{[30
]}

Robin, Christine ^{[31
]}

Khan, Anjum ^{[32
]}

Lenhoff, Stig ^{[33
]}

Grassi, Anna ^{[34
]}

Dobsinska, Veronika ^{[35
]}

Miranda, Nuno ^{[36
]}

Jimenez, Maria-Jose ^{[37
]}

Yonal-Hindilerden, Ipek ^{[38
]}

Wilson, Keith ^{[39
]}

Averbuch, Dina ^{[40
,41
]}

Cesaro, Simone ^{[42
]}

Xhaard, Alienor ^{[43
]}

Knelange, Nina ^{[44
]}

Styczynski, Jan ^{[45
]}

Mikulska, Malgorzata ^{[46
,47
]}

de la Camara, Rafael ^{[25
]}

机构：

[1] Karolinska Univ Hosp Huddinge, Karolinska Comprehens Canc Ctr, Dept Cellular Therapy & Allogene Stem Cell Transp, Stockholm, Sweden

[2] Karolinska Inst, Dept Med Huddinge, Div Hematol, Stockholm, Sweden

[3] European Soc Blood & Marrow Transplantat EBMT Dat, Dept Med Stat & Bioinformat, Leiden, Netherlands

[4] Hosp Clin Univ Valencia, Hematol Dept, Valencia, Spain

[5] Hosp Clin Univ Valencia, Fdn Invest Hosp Clin Comun Valenciana INCL, Inst Invest Sanit, Valencia, Spain

[6] Univ Vita Salute San Raffaele, Osped San Raffaele, IRCCS, Milan, Italy

[7] Copenhagen Univ Hosp, Dept Hematol, Copenhagen, Denmark

[8] Pavlov Univ, Raisa Mem RM Gorbacheva Res Inst, St Petersburg, Russia

[9] Karolinska Inst, Dept Lab Med, Stockholm, Sweden

[10] Gazi Univ, Dept Hematol, Fac Med, Ankara, Turkiye

[11] Newcastle Biomed Res Ctr, Translat & Clin Res Inst, Newcastle Upon Tyne, Tyne & Wear, England

[12] Newcastle Biomed Res Ctr, Natl Inst Hlth & Care Res NIHR, Newcastle Upon Tyne, Tyne & Wear, England

[13] Sahlgrens Univ Hosp, Dept Hematol, Gothenburg, Sweden

[14] Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Internal Med, Gothenburg, Sweden

[15] Hop Lyon Sud, Serv Hematol, Lyon, France

[16] Univ Hosp Gasthuisberg, Dept Hematol, Leuven, Belgium

[17] Inst Portugues Oncol Porto, Marrow Transplant Dept, Porto, Portugal

[18] Fdn Policlin Univ Agostino Gemelli Ist Ricovero &, Dipartimento Diagnost Immagini Radioterapia Oncol, Rome, Italy

[19] Med Univ Vienna, St Anna Childrens Hosp, Dept Pediat & Adolescent Med, Vienna, Austria

[20] Univ Hosp Brno, Dept Internal Med Hematol & Oncol, Brno, Czech Republic

[21] Masaryk Univ, Dept Internal Med Hematol & Oncol, Brno, Czech Republic

[22] Royal Marsden Hosp, Haematol Oncol Unit, London, England

[23] Ankara Univ, Dept Hematol, Fac Med, Ankara, Turkiye

[24] Uppsala Univ Hosp, Dept Hematol, Uppsala, Sweden

[25] Hosp Univ Princesa, Dept Hematol, Madrid, Spain

[26] Univ Hosp Bristol & Weston Natl Hlth Serv NHS Fdn, Bristol, Avon, England

[27] Nottingham Univ Hosp, Dept Haematol, Nottingham, England

[28] Univ Murcia, Hosp Univ Morales Meseguer, Dept Hematol, Inst Murciano Invest Biosanit IMIB Arrixaca, Murcia, Spain

[29] Manchester Royal Infirm, Clin Haematol Dept, Manchester, England

[30] Univ Hosp Eppendorf, Dept Stem Cell Transplantat, Hamburg, Germany

[31] Henri Mondor Hosp, AP HP, Dept Hematol, Creteil, France

[32] Leeds Teaching Hosp NHS Trust, Dept Haematol, Leeds, W Yorkshire, England

[33] Skanes Univ Hosp, Dept Hematol, Lund, Sweden

[34] Azienda Sociosanit Terr ASST Papa Giovanni XXIII, Bone Marrow Transplantat Unit, Bergamo, Italy

[35] Comenius Univ, Natl Inst Childrens Dis, Dept Pediat Hematol & Oncol, Bratislava, Slovakia

[36] Inst Portugues Oncol Francisco Gentil, Dept Haematol, Lisbon, Portugal

[37] Hosp Badalona Germans Trias & Pujol, Inst Catala Oncol ICO, Dept Clin Haematol, Badalona, Spain

[38] Istanbul Univ, Istanbul Med Fac, Adult Hematopoiet Stem Cell Transplant Ctr, Istanbul, Turkiye

[39] Univ Cardiff, Blood & Bone Marrow Transplantat Dept, Cardiff, Wales

[40] Hebrew Univ Jerusalem, Hadassah Med Ctr, Pediat Infect Dis Unit, Jerusalem, Israel

[41] Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel

[42] Azienda Osped Univ Integrata, Pediat Hematol Oncol, Verona, Italy

[43] Hop St Louis, Hematol Transplantat Unit, Dept Hematol, Paris, France

[44] European Soc Blood & Marrow Transplantat EBMT Dat, European Soc Blood & Marrow Transplantat EBMT, Leiden Study Unit, Leiden, Netherlands

[45] Nicolaus Copernicus Univ Torun, Dept Pediat Hematol & Oncol, Coll Med, Bydgoszcz, Poland

[46] Univ Genoa, Div Infect Dis, Genoa, Italy

[47] Osped Policlin San Martino, Genoa, Italy

来源：

FRONTIERS IN IMMUNOLOGY | 2023年 / 14卷

关键词：

COVID-19; allogeneic; stem cell transplantation; CMV; risk factors; THERAPY;

D O I：

10.3389/fimmu.2023.1125824

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

IntroductionCOVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. MethodsThis study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic. ResultsThe median age was 50.3 years (min - max; 1.0 - 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min - max; 0.0 - 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 - 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p<.0001), worse performance status (p<.0001), contracting COVID-19 within the first 30 days (p<.0001) or 30 - 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p<.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022. DiscussionAlthough the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.

引用

页数：11

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