Cytomegalovirus viremia, disease, and impact on relapse in T-cell replete peripheral blood haploidentical hematopoietic cell transplantation with post-transplant cyclophosphamide

Incidence, features, and outcomes of cytomegalovirus DNAemia in unmanipulated haploidentical allogeneic hematopoietic stem cell transplantation with post‐transplantation cyclophosphamide

“…The above observation could be explained, at least in part, by the delay in CD4 + T‐cell reconstitution apparently experienced by patients undergoing haplo‐HSCT, in comparison with HLA‐matched allo‐HSCTs . This might also account for the increased incidence of CMV disease seemingly occurring in our cohort and reported by other groups and the high rate of CMV drug resistance among patients receiving PET after haplo‐HSCT, presumably linked to persistent viral replication . In the absence of data on CMV‐specific T‐cell immunity, this is nevertheless merely speculative, yet our data suggest that OM and NRM in patients undergoing haplo‐HSCT by days 180 and 365 are not different from that in patients subjected to other allo‐HSCT types, as has been previously reported …”

New advances in the management of cytomegalovirus in allogeneic haemopoietic stem cell transplantation

“…Pre‐transplant recipient and/or donor CMV seropositivity is also associated with reduced survival and increased transplant‐related mortality compared with CMV seronegative pairs . Other well established and emerging risk factors for CMV include graft versus host disease (GVHD), corticosteroid use, umbilical cord transplants, haploidentical transplants with post‐transplant cyclophosphamide and T‐cell depleted grafts …”

“…3 Other well established and emerging risk factors for CMV include graft versus host disease (GVHD), corticosteroid use, umbilical cord transplants, haploidentical transplants with posttransplant cyclophosphamide and T-cell depleted grafts. [4][5][6] However, the increasing complexity and use of T-cell depleting conditioning regimens in HSCT have significantly impacted on the timing and kinetics of CMV viraemia in the post-transplant period. 1 CMV reactivation is no longer confined to the early post-HSCT period (<100 days) but may occur months later and with multiple recurrences despite adequate treatment.…”

Herpesvirus infection following allogenic hematopoietic stem cell transplantation with TCRaβ and CD19 depletion: risk factors and outcome

“…Согласно полученным в настоящей работе данным, применение TCRaβ и CD19 деплеции ассо-циировано со значительным риском возникновения ЦМВ-виремии. Однако стоит отметить, что исполь-зование альтернативных методов (in vivo, ex vivo) Т-клеточной деплеции при ТГСК от гаплоидентичного донора, включая CD34-селекцию, алемтузумаб и пост-трансплантационный циклофосфамид, в равной сте-пени обусловливает повышение вероятности ЦМВ-ви-ремии [31][32][33][34]. Единственным достоверным отличием от нашей группы пациентов является тот факт, что при использовании платформы CD34-селекции не отмечено переноса цитомегаловируса ЦМВ-негатив-ному реципиенту от ЦМВ-позитивного донора [34].…”

“…В моно-и мультива-риантных анализах получено значимое влияние на риск ЦМВ-виремии, предшествующей острой РТПХ > II стадии, серопозитивности реципиента до ТГСК и наличия у пациента злокачественного заболевания. КВ ЭБВ-инфекции -33% (95% ДИ [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Фактором риска ЭБВ-виремии являлась острая РТПХ > II стадии.…”