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

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

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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.

Original languageEnglish
Pages (from-to)885-890
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number6
DOIs
Publication statusPublished - 2014

Fingerprint

Stem Cell Transplantation
B-Cell Lymphoma
Cytomegalovirus
Hematopoietic Stem Cell Transplantation
Recurrence
Confidence Intervals
Acute Myeloid Leukemia
Tissue Donors
Follicular Lymphoma
Survival
Mortality
Siblings
Multivariate Analysis

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Cytomegalovirus (CMV)
  • Lymphoma

ASJC Scopus subject areas

  • Transplantation
  • Hematology
  • Medicine(all)

Cite this

@article{fffb8c170d3342ca9c4d5f206b4a4602,
title = "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.",
keywords = "Allogeneic hematopoietic stem cell transplantation, Cytomegalovirus (CMV), Lymphoma",
author = "Jacopo Mariotti and Francesco Maura and Francesco Spina and Luisa Roncari and Anna Dodero and Lucia Farina and Vittorio Montefusco and Cristiana Carniti and Barbara Sarina and Francesca Patriarca and Alessandro Rambaldi and Francesco Onida and Attilio Olivieri and Francesco Zallio and Paolo Corradini",
year = "2014",
doi = "10.1016/j.bbmt.2014.02.015",
language = "English",
volume = "20",
pages = "885--890",
journal = "Biology of Blood and Marrow Transplantation",
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number = "6",

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TY - JOUR

T1 - Impact of cytomegalovirus replication and cytomegalovirus serostatus on the outcome of patients with B cell lymphoma after allogeneic stem cell transplantation

AU - Mariotti, Jacopo

AU - Maura, Francesco

AU - Spina, Francesco

AU - Roncari, Luisa

AU - Dodero, Anna

AU - Farina, Lucia

AU - Montefusco, Vittorio

AU - Carniti, Cristiana

AU - Sarina, Barbara

AU - Patriarca, Francesca

AU - Rambaldi, Alessandro

AU - Onida, Francesco

AU - Olivieri, Attilio

AU - Zallio, Francesco

AU - Corradini, Paolo

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Allogeneic hematopoietic stem cell transplantation

KW - Cytomegalovirus (CMV)

KW - Lymphoma

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U2 - 10.1016/j.bbmt.2014.02.015

DO - 10.1016/j.bbmt.2014.02.015

M3 - Article

VL - 20

SP - 885

EP - 890

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 6

ER -