Acute and Chronic GVHD Are Risk Factors for Cytomegalovirus Infection and Disease

By Dustin Samples - Last Updated: September 13, 2023

A retrospective observational study presented at the 11th Annual Meeting of the Society of Hematologic Oncology (SOHO) in Houston, Texas, investigated the incidence of cytomegalovirus (CMV) infection and CMV disease in adult patients who underwent allogeneic hematopoietic stem-cell transplantation (allo-HSCT). In addition, the study sought to identify the specific risk factors associated with the development of CMV infection and CMV disease.

The study comprised 221 adult patients who underwent their first transplant between 2012 and 2020 at a single medical center in Izmir, Turkey. A comprehensive dataset was collected, encompassing patient demographics, details of the transplant procedure, complications, donor characteristics, and parameters relevant to CMV infection and disease.

At a mean follow-up of 1067 days, 121 patients (54.8%) experienced CMV infection and 18 developed CMV disease (8.1%). Most (91.7%) CMV infections occurred during the early post-transplant period, with the remaining 8.3% happening later.

The study identified common risk factors associated with both CMV infection and CMV disease, including the presence of acute graft-versus-host disease (GVHD) and chronic GVHD. Using a specific conditioning regimen—busulfan plus cyclophosphamide—increased the risk of CMV infection, especially in the early post-transplant period.

When CMV disease occurred, it was more likely to affect the gastrointestinal system in cases involving acute GVHD or a human leukocyte antigen-matched unrelated donor.

An elevated peak level of CMV DNA in the blood during CMV infection was associated with a heightened risk of progressing to CMV disease. Conversely, higher counts of leukocytes, neutrophils, and lymphocytes at the onset of CMV infection were linked to a reduced risk of recurrent CMV infection.

For patients with elevated peak CMV DNA levels during CMV infection or those experiencing cytopenia at the onset of CMV infection, vigilant monitoring is critical for early detection of disease progression and recurrence.

Reference

Gezici B, Güneş AE, Soyer NA, et al. Evaluation of Cytomegalovirus Infection/Disease Frequency and Risk Factors Following Allogeneic Stem Cell Transplantation: A Single Center Experience. Abstract CT-127. Presented at the 11th Annual Meeting of the Society of Hematologic Oncology; September 6-9, 2023; Houston, Texas.

Post Tags:SOHO 2023: GVHD
Advertisement
Advertisement