title: CMV serostatus still has an important prognostic impact in de novo acute leukemia patients after allogeneic stem cell transplantation: a report from the Acute Leukemia Working Party of EBMT.
abstract: We analyzed the prognostic impact of donor and recipient cytomegalovirus (CMV) serostatus in 16,628 de novo acute leukemia patients after allogeneic stem cell transplantation (allo-SCT). Compared with CMV-seronegative recipients who underwent allograft from a CMV-seronegative donor, cases of CMV seropositivity of the donor and/or the recipient showed a significantly decreased 2-year leukemia-free survival (44% vs 49%, P < .001) and overall survival (50% vs 56%, P < .001), and increased nonrelapse mortality (23% vs 20%, P < .001). Both groups showed a comparable relapse incidence and 2-year probability of graft-versus-host disease. The negative prognostic effects of CMV seropositivity of the donor and/or the recipient (vs CMV seronegativity of both) were significantly stronger for acute lymphoblastic leukemia (ALL) than for acute myeloid leukemia (AML), resulting in a markedly reduced 2-year overall survival (46% vs 55% for ALL compared with 52% vs 56% for AML). The important prognostic impact of donor/recipient CMV serostatus remained in a multivariate Cox regression analysis including the other prognostic variables. We conclude that donor and/or recipient CMV seropositivity is still associated with an adverse prognosis in de novo acute leukemia patients after allo-SCT despite the implementation of sophisticated strategies for prophylaxis, monitoring, and (preemptive) treatment of CMV.
authors.affiliation: HELIOS Clinic Berlin Buch, Clinic for Hematology, Oncology and Tumorimmunology, Berlin, Germany;
authors.forename: Martin
authors.initials: M
authors.lastname: Schmidt-Hieber
authors.forename: Myriam
authors.initials: M
authors.lastname: Labopin
authors.forename: Dietrich
authors.initials: D
authors.lastname: Beelen
authors.forename: Liisa
authors.initials: L
authors.lastname: Volin
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ehninger
authors.forename: Jürgen
authors.initials: J
authors.lastname: Finke
authors.forename: Gerard
authors.initials: G
authors.lastname: Socié
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: Nicolaus
authors.initials: N
authors.lastname: Kröger
authors.forename: Arnold
authors.initials: A
authors.lastname: Ganser
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Polge
authors.forename: Igor W
authors.initials: IW
authors.lastname: Blau
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000276:immunology / Q000401:mortality / Q000821:virology*; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000821:virology*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000276:immunology / Q000401:mortality / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000276:immunology / Q000401:mortality / Q000821:virology*; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D000914:Antibodies, Viral