Risk factors and long-term outcomes for human herpesvirus 6 encephalitis in the early period after allogeneic stem cell transplantation.

Autor: Yu Y; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Chen W; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Fu H; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Shi J; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Luo Y; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Yu J; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Lai X; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Liu L; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Ye Y; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Zhang C; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China., Huang H; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China. huanghe@zju.edu.cn.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China. huanghe@zju.edu.cn.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China. huanghe@zju.edu.cn., Zhao Y; Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China. yanminzhao@zju.edu.cn.; Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, PR China. yanminzhao@zju.edu.cn.; Zhejiang Province Engineering Research Center for Stem Cell and Immunity Therapy Zhejiang Province Engineering Laboratory for Stem Cell and Immunity Therapy, Hangzhou, Zhejiang, PR China. yanminzhao@zju.edu.cn.
Jazyk: angličtina
Zdroj: Bone marrow transplantation [Bone Marrow Transplant] 2024 Oct; Vol. 59 (10), pp. 1387-1393. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1038/s41409-024-02332-0
Abstrakt: Human herpesvirus 6 (HHV6) encephalitis is a rare but life-threatening complication for patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, reports on susceptibility factors and clinical outcomes are limited. We enrolled HHV6 encephalitis patients following allo-HSCT between 2018 and 2022, then conducted a 1:4 nested case-control cohort study to evaluate risk factors and long-term outcomes. Among 1350 patients, 20 (1.48%) developed HHV6 encephalitis, with a median onset time of 25.5 days after HSCT. Patient age<30 (odds ratio [OR], 3.24, P = 0.016) and NK cell count<115/ul at 21 days (OR, 6.07, P = 0.018) were identified as independent risk factors in multivariate analysis. Moreover, the HHV6 encephalitis group was significantly associated with higher incidence of grade II-IV graft-versus-host disease (aGVHD) (hazard ratio [HR], 5.52, P < 0.001) and transplant-associated microangiopathy (HR,9.86, P < 0.001), and demonstrated a significantly higher non-relapse mortality (NRM) (HR, 5.28, P = 0.004) and a lower overall survival (HR, 4.34, P = 0.001) or progression-free survival (HR, 3.94, P = 0.001) compared to control group. In conclusion, patients <30 years old or with delayed NK cell recovery are more susceptible to HHV6 encephalitis after allo-HSCT, and patients with HHV6 encephalitis after transplantation have poorer clinical outcomes.
(© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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