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Protective effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients is influenced by conditioning regimen.
Biol Blood Marrow Transplant. 2014 Jan; 20(1):46-52.BB

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.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24120526

Citation

Manjappa, Shivaprasad, et al. "Protective Effect of Cytomegalovirus Reactivation On Relapse After Allogeneic Hematopoietic Cell Transplantation in Acute Myeloid Leukemia Patients Is Influenced By Conditioning Regimen." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 20, no. 1, 2014, pp. 46-52.
Manjappa S, Bhamidipati PK, Stokerl-Goldstein KE, et al. Protective effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients is influenced by conditioning regimen. Biol Blood Marrow Transplant. 2014;20(1):46-52.
Manjappa, S., Bhamidipati, P. K., Stokerl-Goldstein, K. E., DiPersio, J. F., Uy, G. L., Westervelt, P., Liu, J., Schroeder, M. A., Vij, R., Abboud, C. N., Fehniger, T. A., Cashen, A. F., Pusic, I., Jacoby, M., Meera, S. J., & Romee, R. (2014). Protective effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients is influenced by conditioning regimen. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 20(1), 46-52. https://doi.org/10.1016/j.bbmt.2013.10.003
Manjappa S, et al. Protective Effect of Cytomegalovirus Reactivation On Relapse After Allogeneic Hematopoietic Cell Transplantation in Acute Myeloid Leukemia Patients Is Influenced By Conditioning Regimen. Biol Blood Marrow Transplant. 2014;20(1):46-52. PubMed PMID: 24120526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Protective effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients is influenced by conditioning regimen. AU - Manjappa,Shivaprasad, AU - Bhamidipati,Pavan Kumar, AU - Stokerl-Goldstein,Keith E, AU - DiPersio,John F, AU - Uy,Geoffrey L, AU - Westervelt,Peter, AU - Liu,Jingxia, AU - Schroeder,Mark A, AU - Vij,Ravi, AU - Abboud,Camille N, AU - Fehniger,Todd A, AU - Cashen,Amanda F, AU - Pusic,Iskra, AU - Jacoby,Meagan, AU - Meera,Srinidhi J, AU - Romee,Rizwan, Y1 - 2013/10/10/ PY - 2013/08/27/received PY - 2013/10/02/accepted PY - 2013/10/15/entrez PY - 2013/10/15/pubmed PY - 2014/8/13/medline KW - Acute myeloid leukemia KW - Allogeneic hematopoietic cell transplantation KW - CMV KW - Myeloablative KW - Reduced intensity KW - Relapse SP - 46 EP - 52 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 20 IS - 1 N2 - 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. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/24120526/Protective_effect_of_cytomegalovirus_reactivation_on_relapse_after_allogeneic_hematopoietic_cell_transplantation_in_acute_myeloid_leukemia_patients_is_influenced_by_conditioning_regimen_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(13)00449-7 DB - PRIME DP - Unbound Medicine ER -