Blood Virome After Allogeneic Hematopoietic Stem Cell Transplantation.

IF 3.8 4区医学 Q2 IMMUNOLOGY

Open Forum Infectious Diseases Pub Date : 2025-04-10 eCollection Date: 2025-04-01 DOI:10.1093/ofid/ofaf213

Krisztina Hosszu-Fellous, Samuel Cordey, Stavroula Masouridi-Levrat, Federico Simonetta, Florian Laubscher, Christophe Combescure, Anne-Claire Mamez, Federica Giannotti, Sarah Morin, Mylene Docquier, Amandine Pradier, Léna Royston, Yves Chalandon, Dionysios Neofytos, Laurent Kaiser

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引用次数: 0

Abstract

Background: Haploidentical allogeneic hematopoietic cell transplant recipients (allo-HCTr) receiving posttransplant cyclophosphamide (haplo-PTCy) are at higher risk for infectious complications, including viral infections.

Methods: We performed a retrospective, single-center, propensity-score matched-pair study including adult haplo-PTCy and allo-HCTr from human leukocyte antigen (HLA)-matched donors, undergoing transplantation in our institution between 2016 and 2022. For each patient, 4 blood samples (day [D] 0, D30, D90, and D180 posttransplantation) were extracted from the biobank and tested with metagenomic next-generation sequencing (mNGS) to describe the blood virome and identify viral RNA/DNA signatures potentially unrecognized by routinely available tests. Routine and symptom-driven polymerase chain reaction (PCR) test results performed during the study period were reviewed.

Results: Twenty-five matched pairs of haplo-PTCy and HLA-matched allo-HCTr were included in the analysis. Plasma mNGS detected a total of 155 and 190 different viral RNA/DNA signatures in haplo-PTCy and HLA-matched allo-HCTr, respectively between D0 and D180. The number of viral signatures was significantly lower in the haplo-PTCy group compared to HLA-matched allo-HCTr at D90 (-1.0 [95% confidence interval {CI}, -1.7 to -.3]; P = .01) and during the period between D30 and D180 (-1.9 [95% CI, -3.3 to -.5]; P = .01). Certain viral species (Anelloviridae, Epstein-Barr virus) were more prevalent in HLA-matched patients. Symptom-driven PCR tests showed higher infection rates of usual viral pathogens in haplo-PTCy versus HLA-matched allo-HCTr (P = .02).

Conclusions: Frequently deployed, targeted PCR tests showed increased viral infection prevalence in haplo-PTCy patients. Conversely, mNGS testing applied at specific timepoints revealed a lower number of commensal viruses in this patient group. More studies on routine use of mNGS are needed to further assess its clinical relevance and value.

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同种异体造血干细胞移植后的血病毒。

背景：单倍体同种异体造血细胞移植受者（alloo - hctr）在移植后接受环磷酰胺（haploi - ptcy）治疗有较高的感染并发症风险，包括病毒感染。方法：我们进行了一项回顾性、单中心、倾向评分配对研究，包括2016年至2022年在我们机构接受移植的人类白细胞抗原（HLA）匹配供者的成人单倍体ptcy和同种异体hctr。对每位患者，从生物库中提取4份血液样本（移植后第0天、第30天、第90天和第180天），并使用新一代宏基因组测序（mNGS）进行检测，以描述血液病毒组并识别常规检测可能无法识别的病毒RNA/DNA特征。回顾了在研究期间进行的常规和症状驱动型聚合酶链反应（PCR）检测结果。结果：25对匹配的单倍型ptcy和hla匹配的同种异体hctr被纳入分析。血浆mNGS在D0和D180之间的单倍ptcy和hla匹配的alloo - hctr中分别检测到155和190种不同的病毒RNA/DNA特征。在D90（-1.0[95%可信区间{CI}， -1.7至- 0.3]）时，单倍- ptcy组的病毒特征数量显著低于hla匹配的同种异体- hctr组；P = 0.01)和D30至D180期间(-1.9 [95% CI, -3.3至- 0.5]；P = 0.01)。某些病毒种类（无elloviridae， Epstein-Barr病毒）在hla匹配的患者中更为普遍。症状驱动PCR检测显示，与hla匹配的同种异体hctr相比，单倍型ptcy中常见病毒病原体的感染率更高（P = 0.02）。结论：经常部署的靶向PCR检测显示单倍体ptcy患者的病毒感染患病率增加。相反，在特定时间点应用的mNGS测试显示，该患者组中共生病毒的数量较低。需要更多的研究来进一步评估其临床意义和价值。

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

Open Forum Infectious Diseases Medicine-Neurology (clinical)

CiteScore

6.70

自引率

4.80%

发文量

630

审稿时长

9 weeks

期刊介绍： Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.