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CMV reactivation after allogeneic HCT and relapse risk: evidence for early protection in acute myeloid leukemia.
Blood. 2013 Aug 15; 122(7):1316-24.Blood

Abstract

The association between cytomegalovirus (CMV) reactivation and relapse was evaluated in a large cohort of patients with acute myeloid leukemia (AML) (n = 761), acute lymphoblastic leukemia (ALL) (n = 322), chronic myeloid leukemia (CML) (n = 646), lymphoma (n = 254), and myelodysplastic syndrome (MDS) (n = 371) who underwent allogeneic hematopoietic cell transplantation (HCT) between 1995 and 2005. In multivariable models, CMV pp65 antigenemia was associated with a decreased risk of relapse by day 100 among patients with AML (hazard ratio [HR] = 0.56; 95% confidence interval [CI], 0.3-0.9) but not in patients with ALL, lymphoma, CML, or MDS. The effect appeared to be independent of CMV viral load, acute graft-versus-host disease, or ganciclovir-associated neutropenia. At 1 year after HCT, early CMV reactivation was associated with reduced risk of relapse in all patients, but this did not reach significance for any disease subgroup. Furthermore, CMV reactivation was associated with increased nonrelapse mortality (HR = 1.31; 95% CI, 1.1-1.6) and no difference in overall mortality (HR = 1.05; 95% CI, 0.9-1.3). This report demonstrates a modest reduction in early relapse risk after HCT associated with CMV reactivation in a large cohort of patients without a benefit in overall survival.

Authors+Show Affiliations

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. mlgreen@fhcrc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23744585

Citation

Green, Margaret L., et al. "CMV Reactivation After Allogeneic HCT and Relapse Risk: Evidence for Early Protection in Acute Myeloid Leukemia." Blood, vol. 122, no. 7, 2013, pp. 1316-24.
Green ML, Leisenring WM, Xie H, et al. CMV reactivation after allogeneic HCT and relapse risk: evidence for early protection in acute myeloid leukemia. Blood. 2013;122(7):1316-24.
Green, M. L., Leisenring, W. M., Xie, H., Walter, R. B., Mielcarek, M., Sandmaier, B. M., Riddell, S. R., & Boeckh, M. (2013). CMV reactivation after allogeneic HCT and relapse risk: evidence for early protection in acute myeloid leukemia. Blood, 122(7), 1316-24. https://doi.org/10.1182/blood-2013-02-487074
Green ML, et al. CMV Reactivation After Allogeneic HCT and Relapse Risk: Evidence for Early Protection in Acute Myeloid Leukemia. Blood. 2013 Aug 15;122(7):1316-24. PubMed PMID: 23744585.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CMV reactivation after allogeneic HCT and relapse risk: evidence for early protection in acute myeloid leukemia. AU - Green,Margaret L, AU - Leisenring,Wendy M, AU - Xie,Hu, AU - Walter,Roland B, AU - Mielcarek,Marco, AU - Sandmaier,Brenda M, AU - Riddell,Stanley R, AU - Boeckh,Michael, Y1 - 2013/06/06/ PY - 2013/6/8/entrez PY - 2013/6/8/pubmed PY - 2013/11/8/medline SP - 1316 EP - 24 JF - Blood JO - Blood VL - 122 IS - 7 N2 - The association between cytomegalovirus (CMV) reactivation and relapse was evaluated in a large cohort of patients with acute myeloid leukemia (AML) (n = 761), acute lymphoblastic leukemia (ALL) (n = 322), chronic myeloid leukemia (CML) (n = 646), lymphoma (n = 254), and myelodysplastic syndrome (MDS) (n = 371) who underwent allogeneic hematopoietic cell transplantation (HCT) between 1995 and 2005. In multivariable models, CMV pp65 antigenemia was associated with a decreased risk of relapse by day 100 among patients with AML (hazard ratio [HR] = 0.56; 95% confidence interval [CI], 0.3-0.9) but not in patients with ALL, lymphoma, CML, or MDS. The effect appeared to be independent of CMV viral load, acute graft-versus-host disease, or ganciclovir-associated neutropenia. At 1 year after HCT, early CMV reactivation was associated with reduced risk of relapse in all patients, but this did not reach significance for any disease subgroup. Furthermore, CMV reactivation was associated with increased nonrelapse mortality (HR = 1.31; 95% CI, 1.1-1.6) and no difference in overall mortality (HR = 1.05; 95% CI, 0.9-1.3). This report demonstrates a modest reduction in early relapse risk after HCT associated with CMV reactivation in a large cohort of patients without a benefit in overall survival. SN - 1528-0020 UR - https://www.unboundmedicine.com/medline/citation/23744585/CMV_reactivation_after_allogeneic_HCT_and_relapse_risk:_evidence_for_early_protection_in_acute_myeloid_leukemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-4971(20)54287-0 DB - PRIME DP - Unbound Medicine ER -