title: Cytomegalovirus infection in patients who underwent allogeneic hematopoietic stem cell transplantation in Portugal: a five-year retrospective review.
abstract: Cytomegalovirus (CMV) infection is 1 of the leading causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (aHSCT), mainly within the first 100 days after transplantation. We aimed to characterize CMV infection in a cohort of 305 patients with different malignancies undergoing aHSCT at the Portuguese Institute of Oncology of Porto between January 2008 and December 2012. In total, 184 patients (60.3%) developed CMV infection, mainly viral reactivations rather than primary infections (96.2% versus 3.8%, respectively). The majority of patients (166 of 184) developed CMV infection ≤100 days after transplantation, with median time to infection of 29 days (range, 0 to 1285) and median duration of infection of 10 days (range, 2 to 372). Multivariate analysis revealed that CMV infection was increased in donor (D)-/recipient (R)+ and D+/R+ (odds ratio [OR], 10.5; 95% confidence interval [CI], 4.35 to 25.4; P < .001) and in patients with mismatched or unrelated donors (OR, 2.54; 95% CI, 1.34 to 4.80; P = .004). Cox regression model showed that the risk of death was significantly increased in patients >38 years old (OR, 1.89; 95% CI, 1.14 to 3.12; P = .0137), who underwent transplantation with peripheral blood (OR, 3.02; 95% CI, 1.33 to 6.86; P = .008), with mismatched or unrelated donor (OR, 2.16; 95% CI, 1.48 to 3.13; P < .001), and who developed CMV infection (OR, 1.76; 95% CI, 1.07 to 2.90; P = .025). Moreover, patients who developed CMV infection had a significantly reduced median post-transplantation survival (16 versus 36 months; P = .002).
authors.affiliation: Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal; Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal. Electronic address: hugo.sousa@ipoporto.min-saude.pt.
authors.forename: Hugo
authors.initials: H
authors.lastname: Sousa
authors.affiliation: Sorbonne Universités, UPMC Université Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France; INSERM, U1135, CIMI-Paris, Paris, France; AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Service de Virologie, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Boutolleau
authors.affiliation: Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal; Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Ribeiro
authors.affiliation: Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal; Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Ana L
authors.initials: AL
authors.lastname: Teixeira
authors.affiliation: Bone Marrow Transplantation Unit, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Pinho Vaz
authors.affiliation: Bone Marrow Transplantation Unit, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Fernando
authors.initials: F
authors.lastname: Campilho
authors.affiliation: Bone Marrow Transplantation Unit, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Rosa
authors.initials: R
authors.lastname: Branca
authors.affiliation: Bone Marrow Transplantation Unit, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Campos
authors.affiliation: Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Baldaque
authors.affiliation: Virology Service, Portuguese Institute of Oncology of Porto, Porto, Portugal; Molecular Oncology Group, Portuguese Institute of Oncology of Porto, Porto, Portugal; Research Department, Portuguese League Against Cancer (LPCC-NRNorte), Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Medeiros
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D064591:Allografts; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000401:mortality / Q000628:therapy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Cytomegalovirus; Graft-versus-host disease; Hematopoietic stem cell transplantation; Mortality