title: Cytomegalovirus Status and the Outcome of T Cell-Replete Reduced-Intensity Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: Cytomegalovirus (CMV) serostatus of donor and recipient are frequently used in algorithms of donor selection, whereas the impact of CMV reactivation on transplantation-related mortality, leukemia control, and overall survival (OS) remains controversial. Therefore, we retrospectively studied the impact of latent or active CMV infections on the outcome and occurrence of graft-versus-host disease (GVHD) after reduced-intensity conditioning (RIC) allogeneic hematopoietic stem cell transplantation (SCT) in 294 patients during the period from 2004 to 2010. CMV viral load was routinely monitored in plasma using a quantitative PCR. Preemptive antiviral therapy was initiated when the viral load in plasma exceeded a predefined threshold. In a proportional hazards model, a seropositive recipient was significantly associated with increased occurrence of acute GVHD. However the CMV serostatus of both recipient and donor and the presence of active CMV infection was not associated with the occurrence of relapses, chronic GVHD, or OS. We conclude that in the presence of viral load monitoring and preemptive treatment, latent or active CMV infection does not substantially affect the OS after T cell-replete RIC allogeneic SCT.
authors.affiliation: Department of Medical Microbiology, Eijkman Winkler Institute for Microbiology, Infectious Diseases and Inflammation, Utrecht, The Netherlands. Electronic address: f.m.verduynlunel@umcutrecht.nl.
authors.forename: Frans M
authors.initials: FM
authors.lastname: Verduyn Lunel
authors.affiliation: Department of Hematology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Reinier
authors.initials: R
authors.lastname: Raymakers
authors.affiliation: Department of Hematology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Anette
authors.initials: A
authors.lastname: van Dijk
authors.affiliation: Department of Hematology, Utrecht University Medical Center, Utrecht, The Netherlands; Laboratory of Translational Immunology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Lotte
authors.initials: L
authors.lastname: van der Wagen
authors.affiliation: Department of Hematology, Utrecht University Medical Center, Utrecht, The Netherlands; Laboratory of Translational Immunology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Monique C
authors.initials: MC
authors.lastname: Minnema
authors.affiliation: Department of Hematology, Utrecht University Medical Center, Utrecht, The Netherlands; Laboratory of Translational Immunology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Jurgen
authors.initials: J
authors.lastname: Kuball
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000517:prevention & control*; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D011292:Premedication / Q000379:methods; D012189:Retrospective Studies; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000379:methods; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000401:mortality; D014775:Virus Activation; D055815:Young Adult
chemical_list: D000998:Antiviral Agents
keywords: Cytomegalovirus; Reduced intensity; Stem cell transplantation