title: Characterizing human herpes virus 6 following hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Human herpes virus 6 reactivation occurs in approximately 50% of patients following hematopoietic stem cell transplant, however, the significance of human herpes virus 6 reactivation remains uncertain.
  
  
  METHODS
  A retrospective study was conducted analyzing clinical data of patients testing positive for human herpes virus 6 by quantitative polymerase chain reaction following hematopoietic stem cell transplant from 1 January 1998 to 1 October 2011. Data retrieved were used to describe the clinical course and outcome of human herpes virus 6 positive hematopoietic stem cell transplant patients.
  
  
  RESULTS
  Sixty patients were identified who tested positive for human herpes virus 6 by polymerase chain reaction following hematopoietic stem cell transplant. A high proportion of patients were identified in this cohort with acute myeloid leukemia (28.3%), active disease (65%), transplanted with a matched unrelated donor (30%), ≥ 1 antigen mismatched (28.3%) matched unrelated donor, or an umbilical cord graft (25%), and those who received antithymocyte globulin (42.4%). Thirty-eight (63.3%) patients were treated for human herpes virus 6 with foscarnet alone or in combination with intravenous immunoglobulin, whereas 18 (30%) did not require treatment survival at Day 100 was 73.3%.
  
  
  CONCLUSIONS
  This study suggests human herpes virus 6 reactivation occurs shortly after hematopoietic stem cell transplant (median of 25 days (interquartile range, 20-31.75) after hematopoietic stem cell transplant). Many potential risk factors are described in this report. Treatment of human herpes virus 6 predominately consisted of foscarnet with or without intravenous immunoglobulin; however, treatment of human herpes virus 6 was not always warranted. Furthermore, the effect of treatment on patient outcomes is uncertain.
authors.affiliation: Department of Pharmacy, University of Michigan Health System, Ann Arbor, MI, USA ajperis@med.umich.edu.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Perissinotti
authors.affiliation: Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Gulbis
authors.affiliation: Department of Stem Cell Transplantation, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Shpall
authors.affiliation: Oncology Content, Content and Clinical Services, McKesson Specialty Health, The Woodlands, TX, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Howell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D004359:Drug Therapy, Combination; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D015654:Herpesvirus 6, Human / Q000235:genetics / Q000502:physiology*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D014775:Virus Activation; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D016756:Immunoglobulins, Intravenous; D017245:Foscarnet
keywords: Human herpes virus 6; hematopoietic stem cell transplantation