The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the Infectious Diseases Working Party of EBMT
- Creators
- Schmidt-Hieber M.
- Tridello G.
- Ljungman P.
- Mikulska M.
- Knelange N.
- Blaise D.
- Socie G.
- Volin L.
- Blijlevens N.
- Fegueux N.
- Yakoub-Agha I.
- Forcade E.
- Maertens J.
- Chevallier P.
- Passweg J.
- Cornelissen J.
- Russell N.
- Craddock C.
- Bourhis J. H.
- Marchand T.
- Remenyi P.
- Cahn J. Y.
- Michallet M.
- Montoto S.
- Kroger N.
- Glass B.
- Styczynski J.
- Others:
- Schmidt-Hieber, M.
- Tridello, G.
- Ljungman, P.
- Mikulska, M.
- Knelange, N.
- Blaise, D.
- Socie, G.
- Volin, L.
- Blijlevens, N.
- Fegueux, N.
- Yakoub-Agha, I.
- Forcade, E.
- Maertens, J.
- Chevallier, P.
- Passweg, J.
- Cornelissen, J.
- Russell, N.
- Craddock, C.
- Bourhis, J. H.
- Marchand, T.
- Remenyi, P.
- Cahn, J. Y.
- Michallet, M.
- Montoto, S.
- Kroger, N.
- Glass, B.
- Styczynski, J.
Description
It has been shown recently that donor and/or recipient cytomegalovirus (CMV) seropositivity is associated with a significant overall survival (OS) decline in acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). We now analyzed the prognostic impact of the donor/recipient CMV serostatus in 6968 patients with chronic hematological malignancies who underwent allo-HSCT. Donor and/or recipient CMV seropositivity was associated with a significantly reduced 2-year progression-free survival (PFS, 50% vs. 52%, p = 0.03) and OS (62% vs. 65%, p = 0.01). Multivariate Cox regression analyses showed an independent negative prognostic impact of donor and/or recipient CMV seropositivity on PFS (HR, 1.1; 95% CI, 1.0–1.2; p = 0.03), OS (HR, 1.1; 95% CI, 1.0–1.2; p = 0.003), and non-relapse mortality (HR, 1.2; 95% CI, 1.0–1.3; p = 0.02). OS decline was strongest for CMV-seropositive recipients with a CMV-seronegative donor (HR, 1.2; 95% CI, 1.1–1.3), followed by CMV-seropositive patients with a CMV-seropositive donor (HR, 1.1; 95% CI, 1.0–1.2). Conversely, OS did not differ significantly between CMV-seronegative recipients allografted from a CMV-seropositive donor (HR, 1.0; 95% CI, 0.9–1.2) and patients with donor/recipient CMV seronegativity (p = 0.001 for the four groups together). Non-relapse mortality was also significantly (p = 0.01) higher for CMV-seropositive patients with a CMV-seronegative graft (HR, 1.2; 95% CI, 1.1–1.4) than for CMV-seropositive patients with a CMV-seropositive graft (HR, 1.1; 95% CI, 0.9–1.2) or CMV-seronegative recipients with a CMV-seropositive graft (HR, 1.0; 95% CI, 0.8–1.2). Donor and/or recipient CMV seropositivity still results in an OS decline in patients with chronic hematological malignancies who have undergone allo-HSCT. However, this OS decline seems to be lower than that described for acute leukemia patients previously.
Additional details
- URL
- http://hdl.handle.net/11567/957921
- URN
- urn:oai:iris.unige.it:11567/957921
- Origin repository
- UNIGE