The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the Infectious Diseases Working Party of EBMT
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The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the Infectious Diseases Working Party of EBMT. / Schmidt-Hieber, Martin; Tridello, Gloria; Ljungman, Per; Mikulska, Malgorzata; Knelange, Nina; Blaise, Didier; Socié, Gerard; Volin, Liisa; Blijlevens, Nicole; Fegueux, Nathalie; Yakoub-Agha, Ibrahim; Forcade, Edouard; Maertens, Johan; Chevallier, Patrice; Passweg, Jakob; Cornelissen, Jan; Russell, Nigel; Craddock, Charles; Bourhis, Jean Henri; Marchand, Tony; Reményi, Péter; Cahn, Jean Yves; Michallet, Mauricette; Montoto, Silvia; Kröger, Nicolaus; Glaß, Bertram; Styczynski, Jan.
In: ANN HEMATOL, Vol. 98, No. 7, 07.2019, p. 1755-1763.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the Infectious Diseases Working Party of EBMT
AU - Schmidt-Hieber, Martin
AU - Tridello, Gloria
AU - Ljungman, Per
AU - Mikulska, Malgorzata
AU - Knelange, Nina
AU - Blaise, Didier
AU - Socié, Gerard
AU - Volin, Liisa
AU - Blijlevens, Nicole
AU - Fegueux, Nathalie
AU - Yakoub-Agha, Ibrahim
AU - Forcade, Edouard
AU - Maertens, Johan
AU - Chevallier, Patrice
AU - Passweg, Jakob
AU - Cornelissen, Jan
AU - Russell, Nigel
AU - Craddock, Charles
AU - Bourhis, Jean Henri
AU - Marchand, Tony
AU - Reményi, Péter
AU - Cahn, Jean Yves
AU - Michallet, Mauricette
AU - Montoto, Silvia
AU - Kröger, Nicolaus
AU - Glaß, Bertram
AU - Styczynski, Jan
PY - 2019/7
Y1 - 2019/7
N2 - It has been shown recently that donor and/or recipient cytomegalovirus (CMV) seropositivity is associated with a significant overall survival (OS) decline in acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). We now analyzed the prognostic impact of the donor/recipient CMV serostatus in 6968 patients with chronic hematological malignancies who underwent allo-HSCT. Donor and/or recipient CMV seropositivity was associated with a significantly reduced 2-year progression-free survival (PFS, 50% vs. 52%, p = 0.03) and OS (62% vs. 65%, p = 0.01). Multivariate Cox regression analyses showed an independent negative prognostic impact of donor and/or recipient CMV seropositivity on PFS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.03), OS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.003), and non-relapse mortality (HR, 1.2; 95% CI, 1.0-1.3; p = 0.02). OS decline was strongest for CMV-seropositive recipients with a CMV-seronegative donor (HR, 1.2; 95% CI, 1.1-1.3), followed by CMV-seropositive patients with a CMV-seropositive donor (HR, 1.1; 95% CI, 1.0-1.2). Conversely, OS did not differ significantly between CMV-seronegative recipients allografted from a CMV-seropositive donor (HR, 1.0; 95% CI, 0.9-1.2) and patients with donor/recipient CMV seronegativity (p = 0.001 for the four groups together). Non-relapse mortality was also significantly (p = 0.01) higher for CMV-seropositive patients with a CMV-seronegative graft (HR, 1.2; 95% CI, 1.1-1.4) than for CMV-seropositive patients with a CMV-seropositive graft (HR, 1.1; 95% CI, 0.9-1.2) or CMV-seronegative recipients with a CMV-seropositive graft (HR, 1.0; 95% CI, 0.8-1.2). Donor and/or recipient CMV seropositivity still results in an OS decline in patients with chronic hematological malignancies who have undergone allo-HSCT. However, this OS decline seems to be lower than that described for acute leukemia patients previously.
AB - It has been shown recently that donor and/or recipient cytomegalovirus (CMV) seropositivity is associated with a significant overall survival (OS) decline in acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). We now analyzed the prognostic impact of the donor/recipient CMV serostatus in 6968 patients with chronic hematological malignancies who underwent allo-HSCT. Donor and/or recipient CMV seropositivity was associated with a significantly reduced 2-year progression-free survival (PFS, 50% vs. 52%, p = 0.03) and OS (62% vs. 65%, p = 0.01). Multivariate Cox regression analyses showed an independent negative prognostic impact of donor and/or recipient CMV seropositivity on PFS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.03), OS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.003), and non-relapse mortality (HR, 1.2; 95% CI, 1.0-1.3; p = 0.02). OS decline was strongest for CMV-seropositive recipients with a CMV-seronegative donor (HR, 1.2; 95% CI, 1.1-1.3), followed by CMV-seropositive patients with a CMV-seropositive donor (HR, 1.1; 95% CI, 1.0-1.2). Conversely, OS did not differ significantly between CMV-seronegative recipients allografted from a CMV-seropositive donor (HR, 1.0; 95% CI, 0.9-1.2) and patients with donor/recipient CMV seronegativity (p = 0.001 for the four groups together). Non-relapse mortality was also significantly (p = 0.01) higher for CMV-seropositive patients with a CMV-seronegative graft (HR, 1.2; 95% CI, 1.1-1.4) than for CMV-seropositive patients with a CMV-seropositive graft (HR, 1.1; 95% CI, 0.9-1.2) or CMV-seronegative recipients with a CMV-seropositive graft (HR, 1.0; 95% CI, 0.8-1.2). Donor and/or recipient CMV seropositivity still results in an OS decline in patients with chronic hematological malignancies who have undergone allo-HSCT. However, this OS decline seems to be lower than that described for acute leukemia patients previously.
KW - Adult
KW - Aged
KW - Allografts
KW - Child
KW - Child, Preschool
KW - Chronic Disease
KW - Cytomegalovirus
KW - Cytomegalovirus Infections/blood
KW - Disease-Free Survival
KW - Donor Selection
KW - Female
KW - Hematologic Neoplasms/blood
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Infant
KW - Male
KW - Middle Aged
KW - Survival Rate
KW - Tissue Donors
U2 - 10.1007/s00277-019-03669-z
DO - 10.1007/s00277-019-03669-z
M3 - SCORING: Journal article
C2 - 30993417
VL - 98
SP - 1755
EP - 1763
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 7
ER -