Co-Reactivation of Cytomegalovirus and Epstein-Barr Virus Was Associated With Poor Prognosis After Allogeneic Stem Cell Transplantation

Frontiers in Immunology

Chen-Hua Yan¹  Lan-Ping Xu¹  Kai-Yan Liu¹  Yu-Qian Sun¹  Yu Wang¹  Xiao-Hui Zhang¹  Rong Wei²  Da-Yu Shi²  Jing-Rui Zhou²  Xiao-Jun Huang³ 

[1] Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing, China;Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Treatment of Hematological Disease, Beijing, China;Peking-Tsinghua Center for Life Sciences, Beijing, China;

关键词: cytomegalovirus;    Epstein-Barr virus;    co-reactivation;    immune reconstitution;    stem cell transplantation;   

DOI  :  10.3389/fimmu.2020.620891

来源: DOAJ

【 摘 要 】

Reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV) is common after hematopoietic stem cell transplantation (HSCT). Previous researches have demonstrated that either CMV or EBV reactivation is associated with poor outcomes of HSCT. However, few studies investigate the impact of CMV and EBV co-reactivation after HSCT. In this study, we described the clinical characteristics of HSCT recipients with CMV and EBV co-reactivation (defined as CMV and EBV viremia occur at the same period of time). We conducted a longitudinal study of 247 patients who underwent HSCT in our center. A total of 24 (9.7%) patients had CMV and EBV co-reactivation. These patients showed higher incidence of viral pneumonitis (P=0.005). Patients with CMV and EBV co-reactivation had significant lower 1-year overall survival (OS) (P=0.004) and lower 1-year leukemia free survival (LFS) (P=0.016). Our further analysis suggested that duration of CMV (P=0.014), EBV (P<0.001), and CD4+CD25+ T cell counts at day 30 post-transplantation (P=0.05) are independent risk factors of virus co-reactivation. In conclusion, patients who developed co-reactivation of CMV and EBV had poor prognosis in terms of lower 1-year OS and LFS, and the CMV and EBV co-reactivation was associated with prolonged CMV or EBV duration and poor CD4+CD25+ T cell reconstitution at day 30 post-transplantation.

【 授权许可】

Unknown