Association between early anti-cytomegalovirus therapy and the incidence of chronic graft-versus-host disease.

Autor: Miyao K; Department of Hematology and Oncology, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan. koutarou380@kosei.anjo.aichi.jp., Murata M; Department of Hematology, Shiga University of Medical Science, Otsu, Japan., Nishida T; Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan., Ozawa Y; Department of Hematology, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan., Uchida N; Department of Hematology, Toranomon Hospital, Tokyo, Japan., Fukuda T; Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan., Doki N; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan., Eto T; Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan., Kawakita T; Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan., Mori Y; Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan., Takada S; Leukemia Research Center, Saiseikai Maebashi Hospital, Maebashi, Japan., Ohigashi H; Department of Hematology, Faculty of Medicine, Hokkaido University, Sapporo, Japan., Tanaka M; Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan., Kanda Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Matsuoka KI; Department of Hematology and Oncology, Okayama University Hospital, Okayama, Japan., Ishimaru F; Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Atsugi, Japan., Atsuta Y; Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan.; Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan., Kanda J; Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan., Terakura S; Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Jazyk: angličtina
Zdroj: International journal of hematology [Int J Hematol] 2024 Nov 14. Date of Electronic Publication: 2024 Nov 14.
DOI: 10.1007/s12185-024-03871-4
Abstrakt: Ganciclovir and foscarnet are two representative anti-cytomegalovirus (CMV) agents. A previous regional study revealed a lower risk of chronic graft-versus-host disease (GVHD) in patients who received pre-emptive foscarnet. We conducted a retrospective nationwide study to confirm the results. A total of 8890 patients aged 16 or older with hematological malignancies who received foscarnet (n = 1555) or ganciclovir (n = 7335) during their first hematopoietic stem cell transplantation (HSCT) were included. The risks of chronic GVHD (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.13-1.40; P < 0.001) and extensive chronic GVHD (HR, 1.16; 95% CI, 1.01-1.33; P = 0.033) were higher with ganciclovir. Among male patients with a female donor, the incidence of extensive chronic GVHD 3 years after HSCT was clearly lower with foscarnet (13%; 95% CI, 9-16%) than with ganciclovir (27%; 95% CI, 25-29%; P < 0.001). In male patients who received HSCT from female donors, foscarnet recipients showed significantly lower incidence of extensive chronic GVHD than ganciclovir recipients, regardless of donor source or previous acute GVHD. While caution is necessary, these results indicate that foscarnet affects alloimmunization and might reduce the incidence of chronic GVHD.
Competing Interests: Declarations Conflict of interest The authors declare that there are no competing financial interest to report. S. Terakura and Y.K are editors of International Journal of Hematology.
(© 2024. Japanese Society of Hematology.)
Databáze: MEDLINE
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