Cytomegalovirus Infection Risk Factors in Allogeneic Hematopoietic Stem Cell Transplantation Can Defibrotide Be a Risk Factor?

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.05.018

Lecturer Zeynep Burçin Yılmaz , Funda Memişoğlu , Emine Hidayet , İrfan Kuku , Mehmet Ali Erkurt , Emin Kaya , İlhami Berber

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Abstract

Introduction and Purpose

Cytomegalovirus (CMV) infection is a prevalent complication, affecting 30% to 50% of patients following Allogeneic Hematopoietic Stem Cell Transplantation (allo-AHCT). This study aims to investigate the risk factors contributing to CMV infection development.

Materials and Methods

A retrospective analysis was performed on 196 patients with hematological malignancies who underwent allo-HSCT in the Stem Cell Transplantation Unit of Inonu University Faculty of Medicine over a 5-year period. Propensity scores were calculated by matching 1:1 for gender and age variables in individuals with CMV infection and in the control group.

Results

Of the 196 patients included in the study, 75 (38.3 %) were female and 121 (61.7 %) were male. According to univariate analysis, CMV infection was seen more frequently in ALL patients than in AML patients (p = .012), while the conditioning regimen (p = 1) did not affect the outcome in terms of risk. Blood cyclosporine levels measured simultaneously with CMV positivity were significant in terms of risk (p = .006). A significant correlation was found between GvHD and CMV infection (p < .001). According to multivariate analysis, receiving defibrotide for VOD prophylaxis posed a risk for CMV positivity.

Conclusion

In our study, only defibrotide prophylaxis was noted as a risk factor in multivariate analysis. While there are ongoing studies for the use of defibrotide in GVHD prophylaxis, more studies are needed to say that it is a definite risk factor for CMV. We believe that focusing on prophylactic treatments used during the transplantation process will be guiding in determining risk factors.

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异基因造血干细胞移植中巨细胞病毒感染的危险因素去纤肽是一个危险因素吗？

介绍和目的：巨细胞病毒（CMV）感染是一种普遍的并发症，影响30%至50%的异体造血干细胞移植（alloo - ahct）患者。本研究旨在探讨影响巨细胞病毒感染发展的危险因素。材料和方法：回顾性分析了5年来在猪野大学医学院干细胞移植中心接受同种异体造血干细胞移植的196例恶性血液病患者。在巨细胞病毒感染个体和对照组中，通过1:1匹配性别和年龄变量来计算倾向得分。结果：纳入研究的196例患者中，女性75例（38.3%），男性121例（61.7%）。根据单因素分析，ALL患者的CMV感染比AML患者更频繁（p = 0.012），而调节方案（p = 1）在风险方面不影响结果。与巨细胞病毒阳性同时测量的血液环孢素水平在风险方面具有显著性（p = 0.006）。GvHD与CMV感染有显著相关性（p < 0.001）。根据多变量分析，接受去纤维肽预防VOD会增加CMV阳性的风险。结论：在我们的研究中，在多变量分析中，只有去纤维肽预防被认为是一个危险因素。虽然目前正在进行去纤维肽用于GVHD预防的研究，但需要更多的研究来证明它是CMV的明确危险因素。我们相信，关注移植过程中使用的预防性治疗将指导确定危险因素。

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.