Early cytomegalovirus infections following allogeneic stem cell transplantation: a comparison between non-malignant and malignant haematological disorders.
The haematological indications for allogeneic stem cell transplantation can be broadly divided into non-malignant and malignant disorders. We compared the incidence and risk factors for post-transplant cytomegalovirus (CMV) infections between these two biologically diverse subgroups of haematological conditions. Out of 105 allogeneic transplants, 64 and 41 were for underlying non-malignant and malignant indications respectively. CMV infections were significantly more frequent (P=0.016) in the malignant subgroup. Pre-transplant recipient CMV seropositivity in both subgroups (negative versus positive; non-malignant,P=0.023; malignant, p<0.001), donor seropositivity (P=0.002) and acute graft-versus-host disease (GVHD) (P=0.02) in the non-malignant subgroup and > or =3 courses of previous cytotoxic therapy (P=0.023) in the malignant subgroup were found to be associated with an increased risk of CMV infections. On multivariate analysis, donor seropositivity in the non-malignant patients (negative versus positive,P=0.022; odds ratio: 0.18) and recipient seropositivity in patients with malignancies (negative versus positive; P=0.001, odds ratio: 0.01) were identified to be significant factors for risk of CMV infection.
Islam
Md Serajul
MS
Department of Haematology, St George's Hospital, London, UK. serajul@doctors.org.uk
Anoop
Parameswaran
P
Rice
Phil
P
Benjamin
Reuben
R
Datta-Nemdharry
Preeti
P
Gordon-Smith
Edward C
EC
Marsh
Judith C W
JC
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D036101:Cord Blood Stem Cell Transplantation; D003586:Cytomegalovirus Infections / Q000453:epidemiology* / Q000635:transmission; D004198:Disease Susceptibility; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000453:epidemiology; D006402:Hematologic Diseases / Q000150:complications / Q000601:surgery*; D019337:Hematologic Neoplasms / Q000150:complications / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000453:epidemiology*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects; D014775:Virus Activation; D055815:Young Adult
D007166:Immunosuppressive Agents