title: Impact of cytomegalovirus replication and cytomegalovirus serostatus on the outcome of patients with B cell lymphoma after allogeneic stem cell transplantation.
abstract: Cytomegalovirus (CMV) replication after allogeneic hematopoietic stem cell transplantation (HSCT) was historically associated with increased nonrelapse mortality (NRM). More recently, different groups have reported an association between CMV replication and reduced risk of acute myeloid leukemia (AML) relapse. Given the conflicting results, we evaluated the impact of CMV replication and other covariates on the outcome of a retrospective cohort of 265 adults with B cell lymphoma receiving allogeneic HSCT from HLA-identical siblings or alternative donors. In time-dependent multivariate analysis, CMV replication, evaluated by pp65 antigenemia, had no independent effect on the risk of relapse (hazard ratio [HR], 1.0; 95% confidence interval [CI], .6 to 1.6; P = .9), although it was associated with a reduced overall survival (HR, 2.0; 95% CI, 1.3 to 3.2; P = .001) and an increased NRM (HR, 2.5; 95% CI, 1.1 to 5.3; P = .01). Consistently, donor and/or recipient CMV seropositivity were not associated with a different outcome relative to CMV double-negative serostatus. In multivariate models, a diagnosis of follicular lymphoma (P < .0001) and pretransplantation complete remission status (P < .0001) were the main independent predictors for improved relapse-free survival. In summary, contrary to what is observed in patients with AML, this report identifies no independent role for CMV replication or serostatus on the relapse of patients with B cell lymphomas undergoing allogeneic HSCT.
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: jacopo.mariotti@istitutotumori.mi.it.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Mariotti
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Maura
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Spina
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Roncari
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Dodero
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Farina
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Montefusco
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Carniti
authors.affiliation: Hematology Unit, Humanitas Cancer Center, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sarina
authors.affiliation: Hematology Unit, Santa Maria della Misericordia Hospital, Udine, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Patriarca
authors.affiliation: Hematology Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rambaldi
authors.affiliation: Bone Marrow Transplantation Center-Hematology, Fondazione Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Onida
authors.affiliation: Department of Internal Medicine, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Attilio
authors.initials: A
authors.lastname: Olivieri
authors.affiliation: Department of Hematology, SS Antonio e Biagio Hospital, Alessandria, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Zallio
authors.affiliation: Department of Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Hematology, Università degli Studi di Milano, Milano, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Corradini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000209:etiology / Q000821:virology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D016393:Lymphoma, B-Cell / Q000097:blood / Q000628:therapy* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014779:Virus Replication / Q000502:physiology*; D055815:Young Adult
keywords: Allogeneic hematopoietic stem cell transplantation; Cytomegalovirus (CMV); Lymphoma