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Factors Associated with Cytomegalovirus Reactivation Following Allogeneic Hematopoietic Stem Cell Transplantation: Human Leukocyte Antigens Might Be Among the Risk Factors.
MedLine Citation:
PMID:  25330521     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: Cytomegalovirus (CMV) is a significant cause of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (AHSCT) recipients. Current practice includes prophylactic and preemptive treatment modalities, which have risks, side effects, and costs of their own. There is no established risk scoring system that applies to all patients. We aimed to investigate the risk factors for CMV reactivation in AHSCT recipients. Materials and Methods: We retrospectively analyzed the risk factors for CMV reactivation in 185 consequent AHSCT recipients transplanted between September 2003 and December 2009 at the Stem Cell Transplantation Unit of Gazi University. Besides the standard transplant-related parameters, HLA antigens were also included among the variables analyzed. Results: Despite the very high rate of donor (94.6%) and recipient (100%) seropositivity, which are the so-called major risk factors in previous reports, our reactivation rate was much lower, with a frequency of 24.9%. The underlying disease, sex, conditioning regimen, and presence of antithymocyte globulin or fludarabine in the conditioning regimen had no impact on reactivation rate. CMV reactivation was significantly more frequent in recipients with graft-versus-host disease (GVHD) compared to those without GVHD (p<0.0001). CMV reactivation was significantly more frequent (p<0.05) in patients with HLA-B14, HLA-DRB1*01, and HLA-DRB1*13 antigens and less frequent in recipients with HLA-A11 and HLA-DRB1*04 antigens (p<0.05). Conclusion: Universal risk factors/scores that apply to all transplant recipients are required for tailored prophylaxis and/or treatment strategies for CMV reactivation. Uncovering the role of genetic factors, including HLA antigens, as possible risk factors might lead the way to risk-adaptive strategies for adoptive cellular therapy and/or vaccination.
Abstract available from the publisher.
Authors:
Kadir Acar; Sahika Zeynep Akı; Zübeyde Nur Ozkurt; Gülendam Bozdayı; Seyyal Rota; Gülsan Türköz Sucak
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Turkish journal of haematology : official journal of Turkish Society of Haematology     Volume:  31     ISSN:  1300-7777     ISO Abbreviation:  Turk J Haematol     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-10-20     Completed Date:  -     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9606065     Medline TA:  Turk J Haematol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  276-285     Citation Subset:  -    
Vernacular Title:
Allojeneik Kök Hücre Nakli Sonrası Sitomegalovirus Reaktivasyonu ile İlişkili Faktörler: İnsan Lökosit Antijenleri Risk Faktörleri Arasında Olabilir.
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