title: CMV reactivation is associated with a lower incidence of relapse after allo-SCT for CML.
abstract: Preemptive therapy at CMV reactivation has diminished post-transplant CMV mortality. Furthermore, recent studies suggest a favorable 'virus-versus-leukemia' effect from reactivating CMV, reducing relapse of AML after SCT. We studied the relationship of CMV reactivation with leukemic relapse in 110 patients with CML receiving HLA-identical sibling SCT between 1993 and 2008. Of these, 79 (72%) were in chronic phase, 5 in second chronic phase, 17 in accelerated phase and 9 in blast phase. A total of 97 patients (88%) received a myeloablative conditioning regimen, 97 received 4-log ex vivo T cell-depleted grafts and 13 received T-replete grafts. CMV reactivation before day 100 was observed in 72 patients (65.5%). At a median follow-up of 6.2 years, CMV reactivation < day 100 as a time-dependent covariate was an independent factor associated with decreased relapse. We conclude that CMV reactivation may contribute to a beneficial GVL effect in CML transplant recipients.
authors.affiliation: Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: S
authors.initials: S
authors.lastname: Ito
authors.forename: P
authors.initials: P
authors.lastname: Pophali
authors.forename: Wu
authors.initials: W
authors.lastname: CO
authors.forename: E K
authors.initials: EK
authors.lastname: Koklanaris
authors.forename: J
authors.initials: J
authors.lastname: Superata
authors.forename: G A
authors.initials: GA
authors.lastname: Fahle
authors.forename: R
authors.initials: R
authors.lastname: Childs
authors.forename: M
authors.initials: M
authors.lastname: Battiwalla
authors.forename: A J
authors.initials: AJ
authors.lastname: Barrett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000821:virology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000601:surgery* / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous; D014775:Virus Activation; D055815:Young Adult
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