Relationship between certain HLA alleles and the risk of cytomegalovirus reactivation following allogeneic hematopoietic stem cell transplantationUniv Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Toronto, Sect Med Oncol & Hematol, Dept Med, Toronto, ON, Canada.;Univ Hlth Network, Div Med Oncol & Hematol, Hans Messner Allogene Blood & Marrow Transplantat, Princess Margaret Canc Ctr, Toronto, ON, Canada..
Univ Hlth Network, Messner Allogene Transplant Program, Div HLA Lab, Lab Med Program, Toronto, ON, Canada.;Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada..
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2022 (English)In: Transplant Infectious Disease, ISSN 1398-2273, E-ISSN 1399-3062, Vol. 24, no 4, article id e13879Article in journal (Refereed) Published
Abstract [en]
Introduction: Evidence is emerging to support an association between certain human leukocyte antigen (HLA) alleles and the risk of cytomegalovirus (CMV) reactivation following allogeneic hematopoietic stem cell transplant (allo-HSCT). The primary aim of this study was to identify HLA alleles associated with resistance or susceptibility to CMV reactivation. Methods: We studied 586 adults who underwent al lo-HSCT for high-risk hematological malignancies. High-resolution HLA typing data were available for recipients and donors. HLA class I and II alleles observed at a frequency of >5% in our population were included in the analysis. A CMV viremia level of more than 200 IU/ml on weekly monitoring was considered to be indicative of CMV reactivation. Results: The median follow-up time in surviving patients was 21 months (range 4-74 months). The cumulative incidence of CMV reactivation at 6 months in the entire cohort was 55% (95% confidence interval [CI] 50.8%-59.2%). Mismatched donors, increasing recipient age, occurrence of acute graft versus host disease and recipient CMV seropositivity were associated with an increased risk of CMV reactivation. HLA B*07:02 (hazard ratio 0.59, 95% CI 0.40-0.83) was associated with a decreased risk of CMV reactivation. Patients who developed CMV reactivation had a lower incidence of relapse, higher transplant-related mortality (TRM) and lower overall survival (OS) than those without CMV reactivation. There was an adverse correlation of OS and TRM with increasing numbers of CMV reactivations. Conclusion: We observed that HLA B*07:02 was associated with a decreased risk of CMV reactivation. CMV reactivation was associated with lower relapse post-transplant, but this did not translate into a survival benefit due to higher TRM.
Place, publisher, year, edition, pages
Wiley John Wiley & Sons, 2022. Vol. 24, no 4, article id e13879
Keywords [en]
allogenic hematopoietic stem cell transplant, cytomegalovirus reactivation, HLA alleles
National Category
Hematology
Identifiers
URN: urn:nbn:se:uu:diva-484457DOI: 10.1111/tid.13879ISI: 000824127500001PubMedID: 35706108OAI: oai:DiVA.org:uu-484457DiVA, id: diva2:1695758
2022-09-142022-09-142024-01-15Bibliographically approved