title: Impact of Human Herpesvirus-6 Reactivation on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: Human herpesvirus-6 (HHV-6) is known to reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with development of acute graft-versus-host disease (GVHD) and nonrelapse mortality (NRM). However, the clinical significance of HHV-6 reactivation after allo-HSCT remains unclear. Therefore, we conducted a retrospective analysis to elucidate the impact of HHV-6 reactivation on transplantation outcomes. Of 236 patients who underwent allo-HSCT, 138 (58.5%) developed HHV-6 reactivation and 98 (41.5%) did not. Univariate analysis indicated that at 3 years, patients with HHV-6 reactivation had significantly higher NRM (27.7% versus 13.7%, P = .003) and worse overall survival (42.1% versus 59.0%, P = .008) than those without reactivation. In multivariate analysis, HHV-6 reactivation was associated with higher incidence of acute GVHD (hazard ratio [HR], 1.87; P = .01), cytomegalovirus reactivation (HR, 2.24; P < .001), and NRM (HR, 2.73; P = .007). Subgroup analysis stratified according to conditioning intensity indicated that a significant impact of HHV-6 reactivation on acute GVHD was observed only in patients who received myeloablative conditioning (MAC). These results indicate that HHV-6 reactivation was associated with development of acute GVHD, cytomegalovirus reactivation, and NRM. Furthermore, adverse impact of HHV-6 reactivation on transplantation outcomes was prominent in the setting of MAC.
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan. Electronic address: jaoki-thk@umin.ac.jp.
authors.forename: Jun
authors.initials: J
authors.lastname: Aoki
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan; Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Numata
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Eri
authors.initials: E
authors.lastname: Yamamoto
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Fujii
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Tanaka
authors.affiliation: Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
authors.forename: Heiwa
authors.initials: H
authors.lastname: Kanamori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D015654:Herpesvirus 6, Human / Q000276:immunology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000009:adverse effects*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012189:Retrospective Studies; D019349:Roseolovirus Infections / Q000276:immunology / Q000401:mortality / Q000628:therapy / Q000821:virology*; D016019:Survival Analysis; D014019:Tissue Donors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D014775:Virus Activation / Q000276:immunology
chemical_list: D019653:Myeloablative Agonists
keywords: Allogeneic hematopoietic stem cell transplantation; Human herpesvirus-6