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Impact of Human Herpesvirus-6 Reactivation on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation.
Biol Blood Marrow Transplant. 2015 Nov; 21(11):2017-22.BB

Abstract

Human herpesvirus-6 (HHV-6) is known to reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with development of acute graft-versus-host disease (GVHD) and nonrelapse mortality (NRM). However, the clinical significance of HHV-6 reactivation after allo-HSCT remains unclear. Therefore, we conducted a retrospective analysis to elucidate the impact of HHV-6 reactivation on transplantation outcomes. Of 236 patients who underwent allo-HSCT, 138 (58.5%) developed HHV-6 reactivation and 98 (41.5%) did not. Univariate analysis indicated that at 3 years, patients with HHV-6 reactivation had significantly higher NRM (27.7% versus 13.7%, P = .003) and worse overall survival (42.1% versus 59.0%, P = .008) than those without reactivation. In multivariate analysis, HHV-6 reactivation was associated with higher incidence of acute GVHD (hazard ratio [HR], 1.87; P = .01), cytomegalovirus reactivation (HR, 2.24; P < .001), and NRM (HR, 2.73; P = .007). Subgroup analysis stratified according to conditioning intensity indicated that a significant impact of HHV-6 reactivation on acute GVHD was observed only in patients who received myeloablative conditioning (MAC). These results indicate that HHV-6 reactivation was associated with development of acute GVHD, cytomegalovirus reactivation, and NRM. Furthermore, adverse impact of HHV-6 reactivation on transplantation outcomes was prominent in the setting of MAC.

Authors+Show Affiliations

Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan. Electronic address: jaoki-thk@umin.ac.jp.Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan; Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan.Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26226409

Citation

Aoki, Jun, et al. "Impact of Human Herpesvirus-6 Reactivation On Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 21, no. 11, 2015, pp. 2017-22.
Aoki J, Numata A, Yamamoto E, et al. Impact of Human Herpesvirus-6 Reactivation on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(11):2017-22.
Aoki, J., Numata, A., Yamamoto, E., Fujii, E., Tanaka, M., & Kanamori, H. (2015). Impact of Human Herpesvirus-6 Reactivation on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 21(11), 2017-22. https://doi.org/10.1016/j.bbmt.2015.07.022
Aoki J, et al. Impact of Human Herpesvirus-6 Reactivation On Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(11):2017-22. PubMed PMID: 26226409.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Human Herpesvirus-6 Reactivation on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation. AU - Aoki,Jun, AU - Numata,Ayumi, AU - Yamamoto,Eri, AU - Fujii,Eriko, AU - Tanaka,Masatsugu, AU - Kanamori,Heiwa, Y1 - 2015/07/27/ PY - 2015/05/28/received PY - 2015/07/21/accepted PY - 2015/7/31/entrez PY - 2015/8/1/pubmed PY - 2016/7/21/medline KW - Allogeneic hematopoietic stem cell transplantation KW - Human herpesvirus-6 SP - 2017 EP - 22 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 21 IS - 11 N2 - Human herpesvirus-6 (HHV-6) is known to reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with development of acute graft-versus-host disease (GVHD) and nonrelapse mortality (NRM). However, the clinical significance of HHV-6 reactivation after allo-HSCT remains unclear. Therefore, we conducted a retrospective analysis to elucidate the impact of HHV-6 reactivation on transplantation outcomes. Of 236 patients who underwent allo-HSCT, 138 (58.5%) developed HHV-6 reactivation and 98 (41.5%) did not. Univariate analysis indicated that at 3 years, patients with HHV-6 reactivation had significantly higher NRM (27.7% versus 13.7%, P = .003) and worse overall survival (42.1% versus 59.0%, P = .008) than those without reactivation. In multivariate analysis, HHV-6 reactivation was associated with higher incidence of acute GVHD (hazard ratio [HR], 1.87; P = .01), cytomegalovirus reactivation (HR, 2.24; P < .001), and NRM (HR, 2.73; P = .007). Subgroup analysis stratified according to conditioning intensity indicated that a significant impact of HHV-6 reactivation on acute GVHD was observed only in patients who received myeloablative conditioning (MAC). These results indicate that HHV-6 reactivation was associated with development of acute GVHD, cytomegalovirus reactivation, and NRM. Furthermore, adverse impact of HHV-6 reactivation on transplantation outcomes was prominent in the setting of MAC. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/26226409/Impact_of_Human_Herpesvirus_6_Reactivation_on_Outcomes_of_Allogeneic_Hematopoietic_Stem_Cell_Transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(15)00499-1 DB - PRIME DP - Unbound Medicine ER -