Cytomegalovirus reactivation after hematopoietic stem cell transplant with CMV-IG prophylaxis: A monocentric retrospective analysis

J Med Virol. 2021 Nov;93(11):6292-6300. doi: 10.1002/jmv.26861. Epub 2021 Feb 19.

Abstract

Human cytomegalovirus (CMV) represents the most common viral infection after hematopoietic stem cell transplant (HSCT), mainly occurring as reactivation from latency in seropositive patients, with a different prevalence based on the extent and timing of seroconversion in a specific population. Here, we retrospectively analyzed a cohort of patients who underwent HSCT at our Institution between 2013 and 2018, all of whom were prophylactically treated with CMV-IG (Megalotect Biotest®), to define the incidence and clinical outcomes of CMV reactivation and clinically significant infection. CMV infection occurred in 69% of our patient series, mainly resulting from reactivation, and CMV clinically significant infection (CS-CMVi) occurred in 48% of prophylactically treated patients. CMV infection and CS-CMVi impacted neither on relapse incidence nor on overall survival nor on relapse-free survival. Moreover, a very low incidence of CMV end-organ disease was documented. CMV-IG used alone as prophylactic therapy after HSCT does not effectively prevent CMV reactivation.

Keywords: CMV; CMV prophylaxis; CMV-specific immunoglobulins; hematopoietic stem cell transplantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Viral / administration & dosage*
  • Antibodies, Viral / immunology
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / immunology
  • Cytomegalovirus / genetics
  • Cytomegalovirus / physiology*
  • Cytomegalovirus Infections / immunology
  • Cytomegalovirus Infections / prevention & control*
  • Cytomegalovirus Infections / virology
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hematopoietic Stem Cell Transplantation / statistics & numerical data
  • Humans
  • Immunoglobulin G / administration & dosage*
  • Male
  • Middle Aged
  • Pre-Exposure Prophylaxis
  • Recurrence
  • Retrospective Studies
  • Virus Activation*
  • Young Adult

Substances

  • Antibodies, Viral
  • Antiviral Agents
  • Immunoglobulin G