Impact of cytomegalovirus replication and cytomegalovirus serostatus on the outcome of patients with B cell lymphoma after allogeneic stem cell transplantation.

Abstract

Cytomegalovirus (CMV) replication after allogeneic hematopoietic stem cell transplantation (HSCT) was historically associated with increased nonrelapse mortality (NRM). More recently, different groups have reported an association between CMV replication and reduced risk of acute myeloid leukemia (AML) relapse. Given the conflicting results, we evaluated the impact of CMV replication and other covariates on the outcome of a retrospective cohort of 265 adults with B cell lymphoma receiving allogeneic HSCT from HLA-identical siblings or alternative donors. In time-dependent multivariate analysis, CMV replication, evaluated by pp65 antigenemia, had no independent effect on the risk of relapse (hazard ratio [HR], 1.0; 95% confidence interval [CI], .6 to 1.6; P = .9), although it was associated with a reduced overall survival (HR, 2.0; 95% CI, 1.3 to 3.2; P = .001) and an increased NRM (HR, 2.5; 95% CI, 1.1 to 5.3; P = .01). Consistently, donor and/or recipient CMV seropositivity were not associated with a different outcome relative to CMV double-negative serostatus. In multivariate models, a diagnosis of follicular lymphoma (P < .0001) and pretransplantation complete remission status (P < .0001) were the main independent predictors for improved relapse-free survival. In summary, contrary to what is observed in patients with AML, this report identifies no independent role for CMV replication or serostatus on the relapse of patients with B cell lymphomas undergoing allogeneic HSCT.

• Authors: Jacopo Mariotti, Francesco Maura, Francesco Spina, Luisa Roncari, Anna Dodero, Lucia Farina, Vittorio Montefusco, Cristiana Carniti, Barbara Sarina, Francesca Patriarca, Alessandro Rambaldi, Francesco Onida, Attilio Olivieri, Francesco Zallio, Paolo Corradini
• Journal: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (Biol Blood Marrow Transplant) Vol. 20 Issue 6 Pg. 885-90 (Jun 2014) ISSN: 1523-6536 [Electronic] United States
• PMID: 24583412 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Cohort Studies
• Cytomegalovirus (physiology)
• Cytomegalovirus Infections (blood, etiology, virology)
• Female
• Hematopoietic Stem Cell Transplantation (methods)
• Humans
• Lymphoma, B-Cell (blood, therapy, virology)
• Male
• Middle Aged
• Retrospective Studies
• Transplantation Conditioning (methods)
• Transplantation, Homologous
• Treatment Outcome
• Virus Replication (physiology)
• Young Adult