Format

Send to

Choose Destination
Ann Hematol. 2019 Apr 16. doi: 10.1007/s00277-019-03669-z. [Epub ahead of print]

The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the Infectious Diseases Working Party of EBMT.

Author information

1
Clinic for Hematology and Oncology, Carl-Thiem-Klinikum, Cottbus, Germany. m.schmidt_hieber@ctk.de.
2
Policlinico G.B. Rossi, Verona, Italy.
3
Karolinska University Hospital, Stockholm, Sweden.
4
DISSAL, Division of Infectious Diseases, University of Genova and IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
5
EBMT Data Office, Leiden, Netherlands.
6
Institute Paoli Calmettes, Marseille, France.
7
Hopital St. Louis, Paris, France.
8
HUCH Comprehensive Cancer Center, Helsinki, Finland.
9
Nijmegen Medical Centre, Radboud University, Nijmegen, Netherlands.
10
CHU Lapeyronie, Montpellier, France.
11
CHU de Lille, LIRIC, INSERM U995, Université de Lille, Lille, France.
12
CHU Bordeaux, Service d'Hematologie et Therapie Cellulaire, Bordeaux, France.
13
University Hospital Gasthuisberg, Leuven, Belgium.
14
CHU Nantes, Nantes, France.
15
University Hospital, Basel, Switzerland.
16
Erasmus MC Cancer Institute, Rotterdam, Netherlands.
17
Nottingham University, Nottingham, UK.
18
Queen Elizabeth Hospital, Birmingham, UK.
19
Gustave Roussy Institute de Cancérologie, Villejuif, France.
20
Centre Hospitalier Universitaire de Rennes, Rennes, France.
21
St. Istvan & St. Laszlo Hospital, Budapest, Hungary.
22
CHU Grenoble Alpes Grenoble, Grenoble, France.
23
Centre Hospitalier Lyon Sud, Lyon, France.
24
Barts Health NHS Trust London, St Bartholomew's Hospital, London, UK.
25
University Hospital Eppendorf, Hamburg, Germany.
26
Clinic for Hematology and Stem Cell Transplantation, HELIOS Clinic Berlin-Buch, Berlin, Germany.
27
Collegium Medicum UMK, University Hospital, Bydgoszcz, Poland.

Abstract

It has been shown recently that donor and/or recipient cytomegalovirus (CMV) seropositivity is associated with a significant overall survival (OS) decline in acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). We now analyzed the prognostic impact of the donor/recipient CMV serostatus in 6968 patients with chronic hematological malignancies who underwent allo-HSCT. Donor and/or recipient CMV seropositivity was associated with a significantly reduced 2-year progression-free survival (PFS, 50% vs. 52%, p = 0.03) and OS (62% vs. 65%, p = 0.01). Multivariate Cox regression analyses showed an independent negative prognostic impact of donor and/or recipient CMV seropositivity on PFS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.03), OS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.003), and non-relapse mortality (HR, 1.2; 95% CI, 1.0-1.3; p = 0.02). OS decline was strongest for CMV-seropositive recipients with a CMV-seronegative donor (HR, 1.2; 95% CI, 1.1-1.3), followed by CMV-seropositive patients with a CMV-seropositive donor (HR, 1.1; 95% CI, 1.0-1.2). Conversely, OS did not differ significantly between CMV-seronegative recipients allografted from a CMV-seropositive donor (HR, 1.0; 95% CI, 0.9-1.2) and patients with donor/recipient CMV seronegativity (p = 0.001 for the four groups together). Non-relapse mortality was also significantly (p = 0.01) higher for CMV-seropositive patients with a CMV-seronegative graft (HR, 1.2; 95% CI, 1.1-1.4) than for CMV-seropositive patients with a CMV-seropositive graft (HR, 1.1; 95% CI, 0.9-1.2) or CMV-seronegative recipients with a CMV-seropositive graft (HR, 1.0; 95% CI, 0.8-1.2). Donor and/or recipient CMV seropositivity still results in an OS decline in patients with chronic hematological malignancies who have undergone allo-HSCT. However, this OS decline seems to be lower than that described for acute leukemia patients previously.

KEYWORDS:

Allogeneic hematopoietic stem cell transplantation; Chronic hematological malignancies; Cytomegalovirus; Serostatus; Survival

PMID:
30993417
DOI:
10.1007/s00277-019-03669-z

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center