Tags

Type your tag names separated by a space and hit enter

Effect of Cytomegalovirus Reactivation on Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Leukemia.
Biol Blood Marrow Transplant. 2016 Feb; 22(2):300-306.BB

Abstract

Recent studies have demonstrated the protective effect of cytomegalovirus (CMV) reactivation against relapse after allogeneic hematopoietic stem cell transplantation (HSCT) for adult myeloid malignancies. We assessed the association of CMV reactivation, defined as the development of CMV antigenemia (at least 1 pp65 antigen-positive cell per 5.0 × 10(4) WBCs) within 100 days after HSCT, with the risk of relapse in 143 patients with pediatric acute leukemia. The median age at HSCT was 7 years, and underlying diseases included acute lymphoblastic leukemia in 101 patients and acute myeloid leukemia in 42. The cumulative incidence of CMV reactivation at day 100 after HSCT was 45.4%. At a median follow-up of 88 months, patients with CMV reactivation had significantly lower 5-year cumulative incidence of relapse compared with patients without CMV reactivation. In a multivariate analysis, high-level CMV reactivation (≥10 pp65 antigen-positive cells) was an independent factor associated with reduced relapse. However, CMV reactivation was also associated with higher nonrelapse mortality (NRM), mostly caused by opportunistic infection after grades II to IV acute graft-versus-host disease (GVHD), which resulted in decreased probability of survival. High-level CMV reactivation was a risk factor for increased NRM and worse overall survival in multivariate analysis. Although CMV reactivation may reduce the risk of relapse after HSCT for pediatric acute leukemia, effective management of severe acute GVHD and better prophylaxis and treatment of opportunistic infections are required to reduce the incidence of NRM and improve survival. Further studies on pediatric HSCT that include a larger number of patients and more homogenous patient cohorts are desirable.

Authors+Show Affiliations

Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan. Electronic address: inagakij@nk-cc.go.jp.Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.Department of Pediatrics, National Kyushu Cancer Center, Fukuoka, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26371373

Citation

Inagaki, Jiro, et al. "Effect of Cytomegalovirus Reactivation On Relapse After Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Leukemia." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 22, no. 2, 2016, pp. 300-306.
Inagaki J, Noguchi M, Kurauchi K, et al. Effect of Cytomegalovirus Reactivation on Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Leukemia. Biol Blood Marrow Transplant. 2016;22(2):300-306.
Inagaki, J., Noguchi, M., Kurauchi, K., Tanioka, S., Fukano, R., & Okamura, J. (2016). Effect of Cytomegalovirus Reactivation on Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Leukemia. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 22(2), 300-306. https://doi.org/10.1016/j.bbmt.2015.09.006
Inagaki J, et al. Effect of Cytomegalovirus Reactivation On Relapse After Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Leukemia. Biol Blood Marrow Transplant. 2016;22(2):300-306. PubMed PMID: 26371373.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Cytomegalovirus Reactivation on Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Leukemia. AU - Inagaki,Jiro, AU - Noguchi,Maiko, AU - Kurauchi,Koichiro, AU - Tanioka,Shinji, AU - Fukano,Reiji, AU - Okamura,Jun, Y1 - 2015/09/11/ PY - 2015/08/07/received PY - 2015/09/08/accepted PY - 2015/9/16/entrez PY - 2015/9/16/pubmed PY - 2016/11/3/medline KW - CMV reactivation KW - HSCT KW - Nonrelapse mortality KW - Pediatric acute leukemia KW - Relapse SP - 300 EP - 306 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol Blood Marrow Transplant VL - 22 IS - 2 N2 - Recent studies have demonstrated the protective effect of cytomegalovirus (CMV) reactivation against relapse after allogeneic hematopoietic stem cell transplantation (HSCT) for adult myeloid malignancies. We assessed the association of CMV reactivation, defined as the development of CMV antigenemia (at least 1 pp65 antigen-positive cell per 5.0 × 10(4) WBCs) within 100 days after HSCT, with the risk of relapse in 143 patients with pediatric acute leukemia. The median age at HSCT was 7 years, and underlying diseases included acute lymphoblastic leukemia in 101 patients and acute myeloid leukemia in 42. The cumulative incidence of CMV reactivation at day 100 after HSCT was 45.4%. At a median follow-up of 88 months, patients with CMV reactivation had significantly lower 5-year cumulative incidence of relapse compared with patients without CMV reactivation. In a multivariate analysis, high-level CMV reactivation (≥10 pp65 antigen-positive cells) was an independent factor associated with reduced relapse. However, CMV reactivation was also associated with higher nonrelapse mortality (NRM), mostly caused by opportunistic infection after grades II to IV acute graft-versus-host disease (GVHD), which resulted in decreased probability of survival. High-level CMV reactivation was a risk factor for increased NRM and worse overall survival in multivariate analysis. Although CMV reactivation may reduce the risk of relapse after HSCT for pediatric acute leukemia, effective management of severe acute GVHD and better prophylaxis and treatment of opportunistic infections are required to reduce the incidence of NRM and improve survival. Further studies on pediatric HSCT that include a larger number of patients and more homogenous patient cohorts are desirable. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/26371373/Effect_of_Cytomegalovirus_Reactivation_on_Relapse_after_Allogeneic_Hematopoietic_Stem_Cell_Transplantation_in_Pediatric_Acute_Leukemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(15)00611-4 DB - PRIME DP - Unbound Medicine ER -