1. Protective effect of cytomegalovirus reactivation on relapse after allogeneic hematopoietic cell transplantation in acute myeloid leukemia patients is influenced by conditioning regimen.
- Author
-
Manjappa S, Bhamidipati PK, Stokerl-Goldstein KE, DiPersio JF, Uy GL, Westervelt P, Liu J, Schroeder MA, Vij R, Abboud CN, Fehniger TA, Cashen AF, Pusic I, Jacoby M, Meera SJ, and Romee R
- Subjects
- Adolescent, Adult, Aged, Female, Graft vs Leukemia Effect, HLA Antigens immunology, Humans, Leukemia, Myeloid, Acute immunology, Leukemia, Myeloid, Acute pathology, Leukemia, Myeloid, Acute virology, Lymphocyte Depletion, Male, Middle Aged, Multivariate Analysis, Risk, Secondary Prevention, Siblings, T-Lymphocytes drug effects, T-Lymphocytes immunology, T-Lymphocytes pathology, Transplantation, Homologous, Unrelated Donors, Cytomegalovirus physiology, Hematopoietic Stem Cell Transplantation, Leukemia, Myeloid, Acute therapy, Myeloablative Agonists therapeutic use, Transplantation Conditioning methods, Virus Activation drug effects
- Abstract
Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic cell transplant (allo-HCT) has been associated with a reduced risk of relapse in patients with acute myeloid leukemia (AML). However, the influence of the conditioning regimen on this protective effect of CMV reactivation after allo-HCT is relatively unexplored. To address this, we evaluated the risk of relapse in 264 AML patients who received T cell-replete, 6/6 HLA matched sibling or 10/10 HLA matched unrelated donor transplantation at a single institution between 2006 and 2011. Of these 264 patients, 206 received myeloablative (MA) and 58 received reduced-intensity conditioning (RIC) regimens. CMV reactivation was observed in 88 patients with MA conditioning and 37 patients with RIC. At a median follow-up of 299 days, CMV reactivation was associated with significantly lower risk of relapse in patients who received MA conditioning both in univariate (P = .01) and multivariate analyses (hazard ratio, .5246; P = .006); however, CMV reactivation did not significantly affect the risk of relapse in our RIC cohort. These results confirm the protective effect of CMV reactivation on relapse in AML patients after allo-HCT reported by previous studies but suggest this protective effect of CMV reactivation on relapse is influenced by the conditioning regimen used with the transplant., (Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF