Cytomegalovirus infection among patients with cancer receiving immune checkpoint inhibitors.

Autor:	Panneerselvam K; Department of Internal Medicine, Baylor College of Medicine, Houston, TX (Kavea Panneerselvam, David Szafron)., Szafron D; Department of Internal Medicine, Baylor College of Medicine, Houston, TX (Kavea Panneerselvam, David Szafron)., Amin RN; Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX (Rajan N. Amin)., Wei D; Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX (Dongguang Wei, Dongfeng Tan)., Tan D; Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX (Dongguang Wei, Dongfeng Tan)., Altan M; Department of Thoracic/Head & Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX (Mehmet Altan)., Okhuysen PC; Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX (Pablo C. Okhuysen)., Shatila M; Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX (Malek Shatila, Gottumukkala Subba Raju, Anusha S. Thomas, Yinghong Wang), USA., Raju GS; Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX (Malek Shatila, Gottumukkala Subba Raju, Anusha S. Thomas, Yinghong Wang), USA., Thomas AS; Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX (Malek Shatila, Gottumukkala Subba Raju, Anusha S. Thomas, Yinghong Wang), USA., Wang Y; Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX (Malek Shatila, Gottumukkala Subba Raju, Anusha S. Thomas, Yinghong Wang), USA.
Jazyk:	angličtina
Zdroj:	Annals of gastroenterology [Ann Gastroenterol] 2022 Sep-Oct; Vol. 35 (5), pp. 522-531. Date of Electronic Publication: 2022 Jul 15.
DOI:	10.20524/aog.2022.0735
Abstrakt:	Background: Immune checkpoint inhibitors (ICIs), used for the treatment of solid and hematologic malignancies, come with the risk of immune-related adverse events (irAEs). Opportunistic infections (e.g., cytomegalovirus [CMV]) mimic irAE symptoms and are understudied in this population. We aimed to describe the incidence, characteristics, treatment and outcomes of CMV infection in ICI-treated patients. Methods: We conducted a single-center retrospective review of all adult patients who were CMV-positive after ICI therapy between 06/2011 and 05/2020. A CMV-positive non-ICI cohort was matched to the ICI group based on age, sex and cancer type. Variables of interest were collected through electronic medical records. Results: The study population comprised 192 patients overall. CMV infection incidence was 7.7% in ICI patients and 12.9% in non-ICI patients (P<0.001). Rates of infection clearance (83% vs. 50%, P=0.002) and recurrence (20% vs. 3%, P=0.037) were higher in ICI patients with hematologic vs. solid tumors, despite similar treatments. All-cause mortality was higher in solid rather than hematologic malignancies in ICI patients (83% vs. 54%, P=0.009); CMV-related mortality was low (3-4%) in both groups. Conclusions: CMV infection occurred in about 7.7% of the ICI-treated cancer population. The infection can be disseminated in multiple organs and has a wide spectrum of clinical symptoms. ICI-treated patients with a hematologic malignancy had higher viral clearance and recurrence than those with solid tumors. In this study, CMV itself did not lead to high mortality in cancer patients. Further study is needed to investigate the role of CMV infection in patients' irAEs and cancer outcome. Competing Interests: Conflict of Interest: None (Copyright: © Hellenic Society of Gastroenterology.)
Databáze:	MEDLINE
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