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Cytomegalovirus DNAemia and risk of mortality in allogeneic hematopoietic stem cell transplantation: Analysis from the Spanish Hematopoietic Transplantation and Cell Therapy Group
Author(s) -
Solano Carlos,
Vázquez Lourdes,
Giménez Estela,
Cámara Rafael,
Albert Eliseo,
Rovira Montserrat,
Espigado Ildefonso,
Calvo Carmen M.,
LópezJiménez Javier,
SuárezLledó María,
Chinea Anabella,
Esquirol Albert,
Pérez Ariadna,
Bermúdez Aránzazu,
Saldaña Raquel,
Heras Inmaculada,
GonzálezHuerta Ana J.,
Torrado Tamara,
Bautista Guiomar,
Batlle Montserrat,
Jiménez Santiago,
Vallejo Carlos,
Barba Pere,
Cuesta María Á.,
Piñana José L.,
Navarro David
Publication year - 2021
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.16147
Subject(s) - medicine , hematopoietic stem cell transplantation , transplantation , cumulative incidence , univariate analysis , cytomegalovirus , retrospective cohort study , incidence (geometry) , cohort , oncology , virology , gastroenterology , immunology , multivariate analysis , viral disease , herpesviridae , virus , physics , optics
The net impact of cytomegalovirus (CMV) DNAemia on overall mortality (OM) and nonrelapse mortality (NRM) following allogeneic hematopoietic stem cell transplantation (allo‐HSCT) remains a matter of debate. This was a retrospective, multicenter, noninterventional study finally including 749 patients. CMV DNA monitoring was conducted by real‐time polymerase chain reaction (PCR) assays. Clinical outcomes of interest were OM and NRM through day 365 after allo‐HSCT. The cumulative incidence of CMV DNAemia in this cohort was 52.6%. A total of 306 out of 382 patients with CMV DNAemia received preemptive antiviral therapy (PET). PET use for CMV DNAemia, but not the occurrence of CMV DNAemia, taken as a qualitative variable, was associated with increased OM and NRM in univariate but not in adjusted models. A subcohort analysis including patients monitored by the COBAS Ampliprep/COBAS Taqman CMV Test showed that OM and NRM were comparable in patients in whom either low or high plasma CMV DNA threshold (<500 vs ≥500 IU/mL) was used for PET initiation. In conclusion, CMV DNAemia was not associated with increased OM and NRM in allo‐HSCT recipients. The potential impact of PET use on mortality was not proven but merits further research.