Original Articles
Vol. 7 (2015): Review Series, Original Articles, Case Reports
https://doi.org/10.4084/mjhid.2015.049

CYTOMEGALOVIRUS REACTIVATION IN ADULT RECIPIENTS OF AUTOLOGOUS STEM CELL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE

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Received: June 10, 2015
Accepted: August 1, 2015
Published: August 25, 2015
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utologoCytomegalovirus, CMV, reactivation, aus, stem cell transplantation
hematology, infectious diseases

Authors

omar ziad alrawi
orawi@khcc.jo
king hussein cancer center, Jordan.
fawzi abdel-latif abdel-rahman
king hussein cancer center, Jordan.
rula alnajjar
king hussein cancer center, Jordan.
husam abujazar
king hussein cancer center, Jordan.
mourad salam
king hussein cancer center, Jordan.
mustafa saad
prince sultan medical center, Saudi Arabia.

Introduction: Cytomegalovirus (CMV) reactivation and infection is a well-recognized complication after allogeneic stem cell transplantation (SCT). Yet only few studies have addressed CMV reactivation after autologous SCT (ASCT).

Methods: We retrospectively reviewed medical records of 210 adult patients who underwent ASCT for lymphoma or multiple myeloma (MM) at a single center from January 1, 2007 until December 31, 2012. All patients were monitored weekly with CMV antigenemia test till day 42 after transplantation, and for 2 months after last positive test in those who had any positive CMV antigenemia test before day 42.

Results: thirty seven (17.6%) patients had CMV reactivation; 23 patients had lymphoma while 14 had MM as the underlying disease. There was no difference in the rate of CMV reactivation between lymphoma and MM patients (20% versus 14.7%, P = 0.32). The majority of the patients were treated with ganciclovir/valganciclovir, all patients had their reactivation resolved with therapy, and none developed symptomatic CMV infection. None of the patients who died within 100 days of transplantation had CMV reactivation. Log rank test showed that CMV reactivation had no effect on the overall survival or the disease-free survival of patients (P values, 0.29 and 0.79, respectively).

Conclusion: In our cohort, CMV reactivation rate after ASCT was 17.6%. There was no difference in reactivation rates between lymphoma and MM patients. With the use of preemptive therapy, symptomatic CMV infection was not documented in any patient in our cohort. CMV reactivation had no impact on patients’ survival post ASCT. 

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Scopus
Google Scholar
Europe PMC
Wingard JR, Chen DY, Burns WH, Fuller DJ, Braine HG, Yeager AM, et al. Cytomegalovirus infection after autologous bone marrow transplantation with comparison to infection after allogenic bone marrow transplantation. Blood 1988;71:1432-37.
Rossini F, Terruzzi E, Cammarota S, Morini F, Fumagalli M, Verga L, et al. Cytomegalovirus infection after autologous stem cell transplantation: incidence and outcome in a group of patients undergoing a surveillance program. Transpl Infect Dis 2005;7:122-25.
Fassas AB, Bolaños-Meade J, Buddharaju LN, Rapoport A, Cottler-Fox M, Chen T, et al. Cytomegalovirus infection and non-neutropenic fever after autologous stem cell transplantation: high rates of reactivation in patients with multiple myeloma and lymphoma. Br J Haematol 2001;112: 237–41.
Boeckh M, Stevens-Ayers T, Bowden RA. Cytomegalovirus pp65 antigenemia after autologous marrow and peripheral blood stem cell transplantation. J Infect Dis 1996;174:907–12.
Hebart H, Schröder A, Löffler J, Klingebiel T, Martin H, Wassmann B, et al. Cytomegalovirus monitoring by polymerase chain reaction of whole blood samples from patients undergoing autologous bone marrow or peripheral blood progenitor cell transplantation. J Infect Dis 1997;175:1490–93.
Bilgrami S, Aslanzadeh J, Feingold JM, Bona RD, Clive J, Dorsky D, et al. Cytomegalovirus viremia, viruria and disease after autologous peripheral blood stem cell transplantation. Bone Marrow Transplant 1999;24:69–73.
Ng AP, Worth L, Chen L, Seymour JF, Prince HM, Slavin M, et al. Cytomegalovirus DNAemia and disease: incidence, natural history and management in settings other than allogeneic stem cell transplantation. Haematologica 2005;90:1672–79.
Han XY. Epidemiologic analysis of reactivated cytomegalovirus antigenemia in patients with cancer. J Clin Microbiol 2007;45:1126–32.
Holmberg LA, Boeckh M, Hooper H, Leisenring W, Rowley S, Heimfeld S, et al. Increased incidence of cytomegalovirus disease after autologous CD34-selected peripheral blood stem cell transplantation. Blood 1999;94:4029–35.
Offidani M, Corvatta L, Olivieri A, Rupoli S, Frayfer J, Mele A, et al. Infectious complications after autologous peripheral blood progenitor cell transplantation followed by G-CSF. Bone Marrow Transplant 1999;24:1079–87.
Bazarbachi A, Labopin M, Ghavamzadeh A, Giebel S, Al-Zahrani H, Ladeb S, et al. Allogeneic matched-sibling hematopoietic cell transplantation for AML: comparable outcomes between Eastern Mediterranean (EMBMT) and European (EBMT) centers. Bone Marrow Transplantation 2013;48:1065-69 .
Boeckh M, Woogerd PM, Stevens-Ayers T, Ray CG, Bowden RA. Factors influencing detection of quantitative cytomegalovirus antigenemia. J Clin Microbiol 1994;32:832-34.
Gema G, Revello MG, Percivalle E, Morini F. Comparison of different immunostaining techniques and monoclonal antibodies to the lower matrix phosphoprotein (pp65) for optimal quantitation of human cytomegalovirus antigenemia. J Clin Microbiol 1992;30:1232-37.
Marchesi F, Mengarelli A, Giannotti F, Tendas A, Anaclerico B, Porrini R, et al. High incidence of post-transplant cytomegalovirus reactivation in myeloma patients undergoing autologous stem cell transplantation after treatment with bortezomib-based regimens: a survey from the rome transplant network. Transplant infectious disease 2014;16:158-164
Kim JH, Goulston C, Sanders S, Lampas M, Zangari M, Tricot G, et al. Cytomegalovirus reactivation following autologous peripheral blood stem cell transplantation for multiple myeloma in the era of novel chemotherapeutics and tandem transplantation. Biol Blood Marrow Transplant 2012;18:1753-58.
Vusirikala M, Wolff SN, Stein RS, Brandt SJ, Morgan DS, Greer JP, et al. Valacyclovir for the prevention of cytomegalovirus infection after allogeneic stem cell transplantation: a single institution retrospective cohort analysis. Bone Marrow Transplant 2001;28:265-70.
Ljungman P, de La Camara R, Milpied N, Volin L, Russell CA, Crisp A, et al. Randomized study of valacyclovir as prophylaxis against cytomegalovirus reactivation in recipients of allogeneic bone marrow transplants. Blood 2002;99:3050-56.

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“CYTOMEGALOVIRUS REACTIVATION IN ADULT RECIPIENTS OF AUTOLOGOUS STEM CELL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE” (2015) Mediterranean Journal of Hematology and Infectious Diseases, 7(1), p. e2015049. doi:10.4084/mjhid.2015.049.