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Biol Blood Marrow Transplant. 2014 Jan;20(1):46-52. doi: 10.1016/j.bbmt.2013.10.003. Epub 2013 Oct 10.

Protective effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients is influenced by conditioning regimen.

Author information

1
Division of Hospital Medicine, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
2
Section of Bone Marrow Transplant and Leukemia, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri.
3
Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri.
4
Section of Bone Marrow Transplant and Leukemia, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri. Electronic address: rromee@dom.wustl.edu.

Abstract

Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic cell transplant (allo-HCT) has been associated with a reduced risk of relapse in patients with acute myeloid leukemia (AML). However, the influence of the conditioning regimen on this protective effect of CMV reactivation after allo-HCT is relatively unexplored. To address this, we evaluated the risk of relapse in 264 AML patients who received T cell-replete, 6/6 HLA matched sibling or 10/10 HLA matched unrelated donor transplantation at a single institution between 2006 and 2011. Of these 264 patients, 206 received myeloablative (MA) and 58 received reduced-intensity conditioning (RIC) regimens. CMV reactivation was observed in 88 patients with MA conditioning and 37 patients with RIC. At a median follow-up of 299 days, CMV reactivation was associated with significantly lower risk of relapse in patients who received MA conditioning both in univariate (P = .01) and multivariate analyses (hazard ratio, .5246; P = .006); however, CMV reactivation did not significantly affect the risk of relapse in our RIC cohort. These results confirm the protective effect of CMV reactivation on relapse in AML patients after allo-HCT reported by previous studies but suggest this protective effect of CMV reactivation on relapse is influenced by the conditioning regimen used with the transplant.

KEYWORDS:

Acute myeloid leukemia; Allogeneic hematopoietic cell transplantation; CMV; Myeloablative; Reduced intensity; Relapse

Comment in

PMID:
24120526
PMCID:
PMC4029772
DOI:
10.1016/j.bbmt.2013.10.003
[Indexed for MEDLINE]
Free PMC Article
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