Association of specific cytomegalovirus genotypes with death from myelosuppression after marrow transplantation.
A retrospective analysis of cytomegalovirus (CMV) genotype was conducted on 281 CMV isolates obtained from marrow transplant recipients. The genotyping was based on sequence variations in the gene encoding envelope glycoprotein B (gB) as detected by restriction analysis of polymerase chain reaction (PCR)-amplified gB DNA. Among all isolates studied, the distribution of gB types 1-4 was 48.4%, 16.4%, 24.6%, and 8.2%, respectively, with only 2.5% of all isolates containing more than one gB type. The association of gB types with acute graft-versus-host-disease (GVHD) and death related to myelosuppression was examined using appropriate multivariable regression models. Covariables in addition to gB type included underlying disease type, donor-recipient HLA matching, donor CMV serostatus, and age as a continuous variable. Death associated with myelosuppression occurred in 2.9% or 4 of 136 patients with gB1, 0% or 0 of 46 patients with gB2, 21.7% or 15 of 69 patients with gB3, and 17.4% or four of 23 patients with gB4. The significant association of CMV gB type with death due to myelosuppression was maintained in a multivariable analysis (P < .001). In addition, the data also suggested that gB types 3 and 4 may be associated with a reduced hazard of grades II to IV acute GVHD.
Torok-Storb
B
B
Fred Hutchinson Cancer Research Center and University of Washington School of Medicine, Seattle 98104-2092, USA.
Boeckh
M
M
Hoy
C
C
Leisenring
W
W
Myerson
D
D
Gooley
T
T
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003587:Cytomegalovirus / Q000235:genetics*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000821:virology*; D006086:Graft vs Host Disease / Q000209:etiology / Q000821:virology; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D007962:Leukocytes / Q000473:pathology*; D014184:Transplantation, Homologous; D014759:Viral Envelope Proteins / Q000235:genetics*
D014759:Viral Envelope Proteins; C040495:glycoprotein B, Simplexvirus