Role of cytomegalovirus reactivation on relapse after allogeneic hematopoietic stem cell transplantation in acute lymphoblastic leukemia.

Q4 Health Professions Clinical hematology international Pub Date : 2024-12-05 eCollection Date: 2024-01-01 DOI:10.46989/001c.125912
Sabrine Mekni, Nour Ben Abdeljelil, Rihab Ouerghi, Rimmel Yosra Kanoun, Siwar Frigui, Dorra Belloumi, Insaf Ben Yaiche, Ines Turki, Anna Chabaane, Lamia Torjemane, Tarek Ben Othman
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Abstract

Cytomegalovirus reactivation (CMV-R) is a frequent complication post-allogeneic hematopoietic stem cell transplantation (allo-HSCT), associated with poor outcomes. Previous studies have demonstrated the protective effect of CMV-R against relapse after allo-HSCT for acute myeloblastic leukemia (AML). However, this impact remains unclear in acute lymphoblastic leukemia (ALL). We conducted a retrospective study on 81 patients with ALL who received allo-HSCT after myeloablative conditioning regimen from matched sibling donors between 2016 and 2022. All patients underwent weekly monitoring for CMV-R by quantitative polymerase chain reaction assay from engraftment until day +100 post allo-HSCT, and received antiviral prophylaxis with acyclovir from day +1 to 6 months after allo-HSCT. Preemptive treatment was initiated when a viremia was higher than 150 copies/mL. The median age was 20 years (range, 5-50 years). After allo-HSCT, 35% of patients developed CMV-R after a median of 39 days (range, 19-100 days). After a median follow-up of 30 months (range, 1-93 months), CMV-R was an independent factor associated with lower cumulative incidence of relapse (CIR) (OR: 0.17; 95% CI [0.03 - 0.98], p = 0.04) without survival benefit. Further studies are needed to validate the protective effect of CMV-R on ALL relapse.

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巨细胞病毒再激活在异基因造血干细胞移植后急性淋巴细胞白血病复发中的作用。
巨细胞病毒再激活(CMV-R)是同种异体造血干细胞移植(alloo - hsct)后常见的并发症,与不良预后相关。先前的研究已经证明CMV-R对急性髓母细胞白血病(AML)的同种异体造血干细胞移植后复发具有保护作用。然而,这种影响在急性淋巴细胞白血病(ALL)中尚不清楚。我们对2016年至2022年间来自匹配的兄弟姐妹供体的81例ALL患者进行了回顾性研究,这些患者在清骨髓调节方案后接受了同种异体造血干细胞移植。所有患者从移植到移植后第100天,通过定量聚合酶链反应法每周监测CMV-R,并在移植后第1天至第6个月接受阿昔洛韦抗病毒预防治疗。当病毒血症高于150拷贝/mL时,开始先发制人的治疗。中位年龄为20岁(范围5-50岁)。同种异体造血干细胞移植后,35%的患者在中位39天(范围19-100天)后出现CMV-R。中位随访30个月(范围1-93个月)后,CMV-R是与较低的累积复发发生率(CIR)相关的独立因素(OR: 0.17;95% CI [0.03 - 0.98], p = 0.04),无生存获益。需要进一步的研究来验证CMV-R对ALL复发的保护作用。
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CiteScore
1.30
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0.00%
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审稿时长
20 weeks
期刊最新文献
Frontline management of multiple myeloma patients: optimizing treatment for patients in the Gulf region. How to perform a high-quality peer review. Delivering bad news in clinical hematology: a personal perspective. Role of cytomegalovirus reactivation on relapse after allogeneic hematopoietic stem cell transplantation in acute lymphoblastic leukemia. Social media in medicine: a personal perspective about opportunities, challenges, and best practice.
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