Cytomegalovirus reactivation in patients treated with allogeneic hematopoietic stem cell transplantation

Abstract

Introduction: Opportunistic CMV reactivation is the most common viral complication after allogenic hematopoietic stem cell transplantation (allo-HSCT). Aim: The aim of our study is to evaluate the frequency of CMV reactivation in relation to the serostatus od the donor and the recipient, and the correlation with the day of leukocyte (Le) and thrombocyte (Tr) engraftment. We compared the frequency of CMV reactivation in myeloablative conditioning (MAC) versus reduced intensity conditioning (RIC), as well as in match related donor (MRD) versus match unrelated donor (MUD) allo-HSCT. We analyzed whether CMV reactivation affected the overall survival (OS) after allo-HSCT. Materials and methods: In a retrospective cohort study, we inspected 42 patients over the age of 18 years, who were treated at the Clinic for Hematology of the Clinical Center of Serbia, from December 2017 to November 2019. Results: Most CMV reactivations were noticed if the recipient (R) was seropositive, and the donor (D) was seronegative (R+/D= 60.0%). The number of CMV DNA copies corelated with the day of leukocyte engraftment of (p = 0.031), but not of thrombocyte engraftment (p = 0.598). The frequency of reactivation in patients treated with RIC was 25.0%, and it was 63.5%, if they were treated with MAC. The intensity of the conditioning regimen corelated with the number of CMV DNA copies (p = 0.025%). There was no correlation found between the type of transplantation (MRD or MUD) and CMV reactivation (p = 0.515). OS after allo-HSCT was 36.39 months (95% CI 26,0 - 46,78). The mean OS in patients with CMV reactivation was 7.39 months (95% CI 5,72 - 9,06), but we did not prove that CMV reactivation had an impact on OS (p = 0.527). Conclusion: CMV reactivation was most common in the R+/Dgroup. CMV reactivation did not affect OS after allo-HSCT in our group of patients.