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Risk factors of human herpesvirus 6 encephalitis/myelitis after allogeneic hematopoietic stem cell transplantation
Author(s) -
Miyashita Naohiro,
Endo Tomoyuki,
Onozawa Masahiro,
Hashimoto Daigo,
Kondo Takeshi,
Fujimoto Katsuya,
Kahata Kaoru,
Sugita Junichi,
Goto Hideki,
Matsukawa Toshihiro,
Hashino Satoshi,
Teshima Takanori
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12682
Subject(s) - myelitis , medicine , encephalitis , hematopoietic stem cell transplantation , human herpesvirus 6 , transplantation , immunology , herpesviridae , viral disease , spinal cord , virus , psychiatry
Abstract Background Human herpesvirus 6 ( HHV ‐6) encephalitis/myelitis is now a well‐known complication after allogeneic stem cell transplantation (allo‐ HSCT ), particularly after cord blood transplantation ( CBT ). In this study, we evaluated the risk factors of HHV ‐6 encephalitis/myelitis. Methods We evaluated 253 patients who received allo‐ HSCT from 2007 to 2015 at our institute. HHV ‐6 encephalitis/myelitis was defined as HHV ‐6 DNA detection in the cerebrospinal fluid or peripheral blood by polymerase chain reaction in the presence of typical manifestations without other concurrent condition that led to the manifestations. Results HHV ‐6 encephalitis/myelitis occurred in 11 patients (4.5%) (9 encephalitis, 3.7%; 2 myelitis, 0.8%). Multivariate analysis showed that CBT , mycophenolate mofetil ( MMF ) for graft‐versus‐host disease prophylaxis, history of allogeneic hematopoietic stem cell transplantation (allo‐ HSCT ), and engraftment syndrome ( ES ) were significantly associated with incidence of HHV ‐6 encephalitis/myelitis ( P =.025, P =.017, P =.017, and P =.014, respectively). Conclusion Although it has been shown that CBT , ES , and history of allo‐ HSCT are risk factors for HHV ‐6 encephalitis/myelitis, our study demonstrated MMF is also a risk factor for the disease.