BK Virus Disease after Allogeneic Stem Cell Transplantation: A Cohort Analysis
Autor: | Joseph H. Antin, Lindsey R. Baden, Gowri Satyanarayana, Nienke M.G. Rorije, Margaret M. Shea, Francisco M. Marty, Sarah P. Hammond, Vincent T. Ho, Robert J. Soiffer |
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Jazyk: | angličtina |
Předmět: |
Male
Transplantation Conditioning Cord blood transplantation medicine.medical_treatment viruses Graft vs Host Disease Hematopoietic stem cell transplantation SIROLIMUS medicine.disease_cause Gastroenterology Severity of Illness Index Graft-versus-host disease PROPHYLAXIS Human BK polyomavirus VERSUS-HOST-DISEASE Prospective Studies Prospective cohort study Incidence (epidemiology) Hazard ratio Hematopoietic Stem Cell Transplantation virus diseases Hematology ASSOCIATION Middle Aged BK virus surgical procedures operative Cord blood Hematologic Neoplasms Female Cord Blood Stem Cell Transplantation Adult medicine.medical_specialty ONSET HEMORRHAGIC CYSTITIS Internal medicine medicine Humans Transplantation Homologous Cyclophosphamide Aged Polyomavirus Infections Transplantation business.industry INTENSITY Mycophenolic Acid Myeloablative Agonists medicine.disease BONE-MARROW-TRANSPLANTATION Allogeneic stem cell transplantation Tumor Virus Infections RECIPIENTS Immunology Chronic Disease RISK-FACTORS business |
Zdroj: | Biology of Blood and Marrow Transplantation, 20(4), 564-570. ELSEVIER SCIENCE INC |
ISSN: | 1083-8791 |
DOI: | 10.1016/j.bbmt.2014.01.014 |
Popis: | The clinical epidemiology of BK virus (BKV) disease after allogeneic hematopoietic stem cell transplantation (HSCT) is not well defined. We evaluated 491 patients transplanted from January 2010 to December 2011 at a single transplant center to assess incidence, severity, and risk factors for BIN disease after HSCT. BIN disease was defined as BIN detection in urine by PCR testing in association with genitourinary symptoms without other concurrent genitourinary conditions. BKV disease occurred in 78 patients (15.9%), for an incidence rate of.47/1000 patient-days (95% confidence interval [CI],.37 to .59); BIN disease was considered severe in 27 patients (5.5%). In multivariate Cox modeling, time-dependent acute graft-versus-host disease (aGVHD) grades ll to IV (adjusted hazard ratio [aHR14.25; 95% CI, 2.51 to 7.21), cord blood HSCT (aHR 2.28; 95% CI, 1.01 to 5.15), post-transplant mycophenolate use (aHR 3.31; 95% CI, 1.83 to 5.99), and high-dose cyclophosphamide conditioning (aHR 2.34, 95% CI 1.45 to 3.77) were significant predictors of BKV disease. Time-dependent aGVHD grades III to IV (aHR 10.5; 95% CI, 4.44 to 25.0) and cord blood HSCT (aHR 5.40; 95% CI, 1.94 to 15.0) were independent risk factors for severe BKV disease. BKV disease is common and is associated with significant and prolonged morbidity after HSCT. Prospective studies are needed to better define the morbidity of post-HSCT BKV disease and inform the design of prophylaxis and treatment trials. (C) 2014 American Society for Blood and Marrow Transplantation. |
Databáze: | OpenAIRE |
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