Prognostic Impact of Cytomegalovirus Reactivation After Transplantation From Cord Blood Compared to Other Donor Sources in Patients With Adult T-Cell Leukemia/Lymphoma in the Pre-Letermovir Era.

IF 2.6 4区医学 Q3 IMMUNOLOGY

Transplant Infectious Disease Pub Date : 2025-07-08 DOI:10.1111/tid.70070

Takuya Fukushima, Hidehiro Itonaga, Hikaru Sakamoto, Wataru Takeda, Masahito Tokunaga, Takeharu Kato, Takuro Kuriyama, Toshiro Kawakita, Machiko Fujioka, Yasuhiko Miyazaki, Naoyuki Uchida, Yasuo Mori, Hirohisa Nakamae, Masao Ogata, Kazunori Imada, Makoto Onizuka, Kazuho Morichika, Yoshinobu Kanda, Takahiro Fukuda, Yoshiko Atsuta, Shigeo Fuji, Makoto Yoshimitsu

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引用次数: 0

Abstract

Background: Cytomegalovirus reactivation (CMV-react) is an indicator for the worse non-relapse mortality (NRM) and overall survival (OS) after allogeneic hematopoietic stem cell transplantation using HLA-matched related donor (MRD) and unrelated donor (URD) for adult T-cell leukemia/lymphoma (ATL). However, it remains unclear whether CMV-react correlates with outcomes after unrelated cord blood (U-CB) transplantation.

Methods: We conducted a retrospective nationwide study to evaluate the impact of CMV-react on the outcomes after posttransplant 100 days. Data were collected from 205, 461, and 268 patients who used MRD, URD, and U-CB, respectively, between 2001 and 2022 and survived without relapse for over 100 days after transplantation.

Results: In multivariate analyses, CMV-react correlated with worse OS in the MRD (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.02-2.39; p = 0.04) and URD groups (HR, 1.45; 95% CI, 1.00-2.09; p = 0.05), but not in the U-CB group (HR, 1.34; 95% CI, 0.88-2.03; p = 0.2). CMV-react correlated with higher NRM in the MRD (HR, 1.79; 95% CI, 1.01-3.16; p = 0.05) and URD groups (HR, 1.68; 95% CI, 1.01-2.82; p = 0.05), but not in the U-CB group (HR, 1.16; 95% CI, 0.62-2.19; p = 0.6). CMV-react did not correlate with the incidence of relapse in any group.

Conclusion: CMV-react was not associated with the outcomes in the U-CB group, while CMV-react correlates with worse OS and NRM in the MRD and URD groups, indicating the need for a more intensive strategy for late-phase complications in U-CB transplantation for ATL with and without CMV-react.

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在letermovir时代之前，脐带血移植后巨细胞病毒再激活对成人t细胞白血病/淋巴瘤患者预后的影响

背景：巨细胞病毒再激活（CMV-react）是成人t细胞白血病/淋巴瘤（ATL）患者使用hla匹配的相关供体（MRD）和非相关供体（URD）进行同种异体造血干细胞移植后较差的非复发死亡率（NRM）和总生存率（OS）的指标。然而，cmv反应是否与非亲属脐带血（U-CB）移植后的预后相关尚不清楚。方法：我们在全国范围内进行了一项回顾性研究，评估巨细胞病毒反应对移植后100天预后的影响。在2001年至2022年期间，分别收集了205,461和268例使用MRD， URD和U-CB的患者的数据，这些患者在移植后100天内没有复发。结果：在多变量分析中，cmv反应与MRD中较差的OS相关(风险比[HR]， 1.56；95%置信区间[CI]， 1.02-2.39；p = 0.04)和URD组(HR, 1.45；95% ci, 1.00-2.09；p = 0.05)， U-CB组无差异(HR, 1.34；95% ci, 0.88-2.03；P = 0.2)。cmv反应与MRD中较高的NRM相关(HR, 1.79；95% ci, 1.01-3.16；p = 0.05)和URD组(HR, 1.68；95% ci, 1.01-2.82；p = 0.05)， U-CB组无差异(HR, 1.16；95% ci, 0.62-2.19；P = 0.6)。cmv反应与复发率无相关性。结论：cmv反应与U-CB组的预后无关，而MRD组和URD组的cmv反应与更差的OS和NRM相关，表明有cmv反应和无cmv反应的ATL U-CB移植晚期并发症需要更强化的策略。

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

Transplant Infectious Disease 医学-传染病学

CiteScore

5.30

自引率

7.70%

发文量

210

审稿时长

4-8 weeks

期刊介绍： Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal. Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.