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- Title
Donor T-cell chimerism and early post-transplant cytomegalovirus viremia in patients treated with myeloablative allogeneic hematopoietic stem cell transplant.
- Authors
Taimur, S.; Askar, M.; Sobecks, R.; Rybicki, L.; Warshawsky, I.; Mossad, S.
- Abstract
Background Cytomegalovirus ( CMV) is a common infection after myeloablative allogeneic hematopoietic stem cell transplant (M-allo HSCT). Achievement of complete donor T-cell chimerism ( CDC-T) post transplant is a measure of immune reconstitution. We investigated the association between CDC-T post M-allo HSCT and the incidence of CMV viremia. Methods We retrospectively reviewed all CMV and chimerism results of 47 patients for the first 6 months post M-allo HSCT. CDC-T was analyzed as a time-varying covariate for association with post M-allo HSCT CMV viremia. Results CMV viremia occurred in 15 (32%) and CDC-T was achieved in 38 (81%) recipients within the first 6 months post M-allo HSCT. On univariable analysis, increased CMV viremia was seen among patients with CDC-T (hazard ratio 2.81 [ P = 0.07, 95% confidence interval = 0.93-8.52]). A 30-day landmark analysis showed that the incidence of CMV viremia at 6 months (regardless of recipient CMV serostatus) was 50% among those who had achieved CDC-T by day 30, and 23% among those who had not ( P = 0.06). Conclusion We conclude that shorter time to CDC-T may be associated with higher risk of CMV viremia. If confirmed in a larger cohort, this might be a marker for risk stratification in the management of CMV in this population.
- Subjects
CYTOMEGALOVIRUSES; VIREMIA; HEMATOPOIETIC stem cell transplantation; T cells; DISEASE incidence; IMMUNE response
- Publication
Transplant Infectious Disease, 2014, Vol 16, Issue 1, p61
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.12163