The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the infectious diseases working party of ebmt - Université de Lille Accéder directement au contenu
Article Dans Une Revue Annals of Hematology Année : 2019

The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the infectious diseases working party of ebmt

Martin Schmidt-Hieber
  • Fonction : Auteur
Gloria Tridello
  • Fonction : Auteur
Per Ljungman
  • Fonction : Auteur
Malgorzata Mikulska
  • Fonction : Auteur
Nina Knelange
  • Fonction : Auteur
Didier Blaise
Gerard Socie
  • Fonction : Auteur
Liisa Volin
  • Fonction : Auteur
Nicole Blijlevens
  • Fonction : Auteur
Nathalie Fegueux
  • Fonction : Auteur
Edouard Forcade
  • Fonction : Auteur
Johan Maertens
  • Fonction : Auteur
Patrice Chevallier
  • Fonction : Auteur
Jakob Passweg
  • Fonction : Auteur
Jan J. Cornelissen
  • Fonction : Auteur
Nigel Russell
  • Fonction : Auteur
Charles Craddock
  • Fonction : Auteur
Jean-Henri Bourhis
  • Fonction : Auteur
Tony Marchand
  • Fonction : Auteur
Peter Remenyi
  • Fonction : Auteur
Jean-Yves Cahn
  • Fonction : Auteur
Mauricette Michallet
  • Fonction : Auteur
Silvia Montoto
  • Fonction : Auteur
Nicolaus Kroger
  • Fonction : Auteur
Bertram Glab
  • Fonction : Auteur
Jan Styczynski
  • Fonction : Auteur

Résumé

It has been shown recently that donor and/or recipient cytomegalovirus (CMV) seropositivity is associated with a significant overall survival (OS) decline in acute leukemia patients who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). We now analyzed the prognostic impact of the donor/recipient CMV serostatus in 6968 patients with chronic hematological malignancies who underwent allo-HSCT. Donor and/or recipient CMV seropositivity was associated with a significantly reduced 2-year progression-free survival (PFS, 50% vs. 52%, p = 0.03) and OS (62% vs. 65%, p = 0.01). Multivariate Cox regression analyses showed an independent negative prognostic impact of donor and/or recipient CMV seropositivity on PFS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.03), OS (HR, 1.1; 95% CI, 1.0-1.2; p = 0.003), and non-relapse mortality (HR, 1.2; 95% CI, 1.0-1.3; p = 0.02). OS decline was strongest for CMV-seropositive recipients with a CMV-seronegative donor (HR, 1.2; 95% CI, 1.1-1.3), followed by CMV-seropositive patients with a CMV-seropositive donor (HR, 1.1; 95% CI, 1.0-1.2). Conversely, OS did not differ significantly between CMV-seronegative recipients allografted from a CMV-seropositive donor (HR, 1.0; 95% CI, 0.9-1.2) and patients with donor/recipient CMV seronegativity (p = 0.001 for the four groups together). Non-relapse mortality was also significantly (p = 0.01) higher for CMV-seropositive patients with a CMV-seronegative graft (HR, 1.2; 95% CI, 1.1-1.4) than for CMV-seropositive patients with a CMV-seropositive graft (HR, 1.1; 95% CI, 0.9-1.2) or CMV-seronegative recipients with a CMV-seropositive graft (HR, 1.0; 95% CI, 0.8-1.2). Donor and/or recipient CMV seropositivity still results in an OS decline in patients with chronic hematological malignancies who have undergone allo-HSCT. However, this OS decline seems to be lower than that described for acute leukemia patients previously.
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Dates et versions

hal-04427087 , version 1 (30-01-2024)

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Citer

Martin Schmidt-Hieber, Gloria Tridello, Per Ljungman, Malgorzata Mikulska, Nina Knelange, et al.. The prognostic impact of the cytomegalovirus serostatus in patients with chronic hematological malignancies after allogeneic hematopoietic stem cell transplantation: a report from the infectious diseases working party of ebmt. Annals of Hematology, 2019, Annals of Hematology, 98, pp.755-1763. ⟨10.1007/s00277-019-03669-z⟩. ⟨hal-04427087⟩

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