Impact of Human Herpesvirus-6 Reactivation on Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation

Autor: Eriko Fujii, Heiwa Kanamori, Masatsugu Tanaka, Eri Yamamoto, Jun Aoki, Ayumi Numata
Rok vydání: 2015
Předmět:
Adult
Male
Oncology
medicine.medical_specialty
Transplantation Conditioning
Adolescent
Herpesvirus 6
Human
viruses
medicine.medical_treatment
Graft vs Host Disease
Roseolovirus Infections
Hematopoietic stem cell transplantation
Recurrence
Internal medicine
Humans
Transplantation
Homologous
Medicine
Clinical significance
Survival analysis
Aged
Retrospective Studies
Univariate analysis
Transplantation
biology
business.industry
Hazard ratio
Hematopoietic Stem Cell Transplantation
virus diseases
Retrospective cohort study
Human herpesvirus-6
Hematology
Middle Aged
Myeloablative Agonists
Precursor Cell Lymphoblastic Leukemia-Lymphoma
biology.organism_classification
Survival Analysis
Tissue Donors
Leukemia
Myeloid
Acute
surgical procedures
operative
Allogeneic hematopoietic stem cell transplantation
Immunology
Female
Virus Activation
Human herpesvirus 6
business
Zdroj: Biology of Blood and Marrow Transplantation. 21(11):2017-2022
ISSN: 1083-8791
DOI: 10.1016/j.bbmt.2015.07.022
Popis: Human herpesvirus-6 (HHV-6) is known to reactivate after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and may be associated with development of acute graft-versus-host disease (GVHD) and nonrelapse mortality (NRM). However, the clinical significance of HHV-6 reactivation after allo-HSCT remains unclear. Therefore, we conducted a retrospective analysis to elucidate the impact of HHV-6 reactivation on transplantation outcomes. Of 236 patients who underwent allo-HSCT, 138 (58.5%) developed HHV-6 reactivation and 98 (41.5%) did not. Univariate analysis indicated that at 3 years, patients with HHV-6 reactivation had significantly higher NRM (27.7% versus 13.7%, P = .003) and worse overall survival (42.1% versus 59.0%, P = .008) than those without reactivation. In multivariate analysis, HHV-6 reactivation was associated with higher incidence of acute GVHD (hazard ratio [HR], 1.87; P = .01), cytomegalovirus reactivation (HR, 2.24; P < .001), and NRM (HR, 2.73; P = .007). Subgroup analysis stratified according to conditioning intensity indicated that a significant impact of HHV-6 reactivation on acute GVHD was observed only in patients who received myeloablative conditioning (MAC). These results indicate that HHV-6 reactivation was associated with development of acute GVHD, cytomegalovirus reactivation, and NRM. Furthermore, adverse impact of HHV-6 reactivation on transplantation outcomes was prominent in the setting of MAC.
Databáze: OpenAIRE
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