Cytomegalovirus reactivation posthematopoietic stem cell transplantation (HSCT) and type of graft: A step toward rationalizing CMV testing and positively impacting the economics of HSCT in developing countries

Pediatr Blood Cancer. 2017 Nov;64(11). doi: 10.1002/pbc.26639. Epub 2017 May 22.

Abstract

We aimed to determine a correlation between cytomegalovirus reactivation post hematopoeitic stem cell transplantation (post-HSCT) with the type of graft source, defining children at risk. We analyzed data on children less than 18 years of age undergoing HSCT from 2002 to May 2016 (n = 464). Correlation between reactivation and graft source was analyzed statistically. Reactivation occurred in 3% of children with matched-related donor (MRD) transplants, 33.3% with unrelated peripheral blood stem cells, 17.4% with unrelated cords, and 36.5% (15/41) with mismatched or haploidentical grafts (P = <0.0001). MRD does not warrant weekly PCR, unlike unrelated or haploidentical donors, thus defining protocols for developing countries with limited resources.

Keywords: cytomegalovirus and graft source; economics of HSCT; pediatrics.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / economics*
  • Cytomegalovirus Infections / virology
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / economics*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prognosis
  • Transplantation Conditioning
  • Virus Activation*