Early CMV-replication after allogeneic stem cell transplantation is associated with a reduced relapse risk in lymphoma

Leuk Lymphoma. 2017 Apr;58(4):822-833. doi: 10.1080/10428194.2016.1217524. Epub 2016 Aug 10.

Abstract

A preventive effect of early human cytomegalovirus (HCMV) replication was evaluated in 136 non-Hodgkin lymphoma (NHL) patients with mature B-cell NHLs (n = 94), and mature T- and NK-cell NHLs (n = 42) after allogeneic stem cell transplantation (alloSCT). Most study-patients (85%) had received at least 2 cycles of chemotherapy and 60% had also received an autograft prior to alloSCT. First detection of CMV-replication by HCMV antigenemia/viremia was found at a median of day +33 after alloSCT. The cumulative incidence of relapse at 5 years after alloSCT was 38% (95% confidence interval [95%CI]: 26-49) in 82 patients without compared to 22% (95%CI: 8-37) in 54 patients with HCMV antigenemia/viremia (p = .013). A decreased relapse risk of HCMV replication was confirmed by multivariate analysis for HCMV antigenemia/viremia (Hazard ratio [HR]: 0.29, 95%CI: 0.11-0.76, p < .014). This report demonstrated a possible improvement of relapse incidence after replicative HCMV infection in patients with NHL after alloSCT.

Keywords: HCMV; alloSCT; lymphoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cytomegalovirus / physiology*
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / prevention & control
  • Female
  • Graft vs Host Disease / etiology
  • Graft vs Host Disease / prevention & control
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Lymphoma / complications*
  • Lymphoma / mortality
  • Lymphoma / pathology*
  • Lymphoma / therapy
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Prognosis
  • Proportional Hazards Models
  • Retreatment
  • Transplantation Conditioning / adverse effects
  • Transplantation, Homologous
  • Viremia
  • Virus Replication*
  • Young Adult