09.07.21

CMV GI disease viral load patterns after allo HCT

Kang HM, Kim SK, Ryu IH, et al. Clinical Characteristics and Viral Load Patterns in Children With Cytomegalovirus Gastrointestinal Disease After Allogeneic Hematopoietic Stem Cell Transplantation. Bone Marrow Transplantation. 2021; (doi: 10.1038/s41409-021-01394-8).

After allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children, it is essential to actively monitor and manage cytomegalovirus (CMV) reactivation, researchers report. This is particularly important in children with delayed CD4+ and CD8+ T-cell reconstitution after allo-HSCT. The retrospective cohort study sought to characterize the clinical characteristics of children with CMV gastrointestinal (CMV GI) disease post-transplantation. Among 756 patients <19 years old who underwent allo-HSCT over an 11-year period, 55.5% (N=420) exhibited post-transplant CMV DNAemia and 2.9% were diagnosed with CMV GI diseases. For 68.2% (N=15) of the 22 patients with CMV GI disease, the condition was diagnosed <100 days of transplant; 13.6% (N=3) did not have concurrent CMV DNAemia. Based on the patterns of CMV viremia initiation and duration post-transplant, patients were divided into five groups. Patients with waxing and waning CMV viral load titers >100 days post-transplant (groups 1-3) had lower CD4+ and CD8+ T cell counts 3 months post-transplant, compared with patients who had CMV DNAemia only prior to 100 days post-transplant and those without concurrent CMV DNAemia (groups 4–5). Groups 1-3 also had increased 1-year all-cause mortality compared with groups 4-5, at 42.8% vs. 0%.

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