Comparison of Cytomegalovirus Reactivation in Children After Allogeneic Hematopoietic Cell Transplantation in 2 Transplant Eras

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2024-09-03 DOI:10.1016/j.transproceed.2024.08.028

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引用次数: 0

Abstract

Background

Reactivation of cytomegalovirus (CMV) is typically considered harmless as long as the immune system remains unaffected by medications or other factors. CMV reactivation may occur as a result of acute graft-versus-host disease of Grades II to IV. One possible factor contributing to this risk is the rise in the number of donors who lack genetic similarities or relationships. We hypothesized that the anti-CMV IgG level before transplantation could potentially serve as an indicator of the likelihood of CMV reactivation following hematopoietic cell transplantation.

Methods

We examined a cohort of young individuals who underwent allogeneic HCT between 1998 and 2022 to evaluate the occurrence of CMV reactivation. The patients were divided into 2 time periods: 1998 to 2016 (comparison group) and 2017 to 2022 (intervention group).

Results

Between 1998 and 2016, 292 patients underwent hematopoietic HCT. Recipients from 2017 to 2022 experienced a slightly higher risk of CMV reactivation than those from 1998 to 2016. The comparison of prophylactic and preemptive medication showed no significant difference between the periods (P = .32). Patients treated from 1998 to 2016 experienced a 23% decrease in the risk of symptomatic CMV reactivation and related illnesses compared to those treated from 2017 to 2022 (P = .08 and .15, respectively).

Conclusions

Our study showed that the intervention group had more symptomatic CMV reactivations. Various factors may contribute to this, including CD19-directed immunotherapy and the CMV status of the recipient before transplantation.

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比较两个移植时代异基因造血细胞移植后儿童巨细胞病毒再激活情况

背景：只要免疫系统不受药物或其他因素的影响，巨细胞病毒（CMV）再活化通常被认为是无害的。CMV 再激活可能会导致 II 级至 IV 级急性移植物抗宿主疾病。导致这种风险的一个可能因素是缺乏基因相似性或关系的供体数量增加。我们假设，移植前的抗 CMV IgG 水平有可能成为造血细胞移植后 CMV 再激活可能性的指标：我们对 1998 年至 2022 年间接受异基因 HCT 的年轻人进行了研究，以评估 CMV 再激活的发生率。这些患者被分为两个时间段：1998 年至 2016 年（对比组）和 2017 年至 2022 年（干预组）：1998年至2016年间，292名患者接受了造血干细胞移植。2017年至2022年的受者发生CMV再激活的风险略高于1998年至2016年的受者。预防性用药和预防性用药的比较显示，这两个时期之间没有显著差异（P = .32）。与2017年至2022年接受治疗的患者相比，1998年至2016年接受治疗的患者发生无症状CMV再激活和相关疾病的风险降低了23%（P = .08和.15）：我们的研究表明，干预组的无症状CMV再激活率更高。这可能是多种因素造成的，包括 CD19 引导的免疫疗法和受者在移植前的 CMV 状态。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.