Cytomegalovirus reactivation is associated with a lower rate of early relapse in myeloid malignancies independent of in-vivo T cell depletion strategy
Cytomegalovirus reactivation is associated with a lower rate of early relapse in myeloid malignancies independent of in-vivo T cell depletion strategy
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DOI：
10.1016/j.leukres.2017.02.009
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发表时间：
2017-06-01
影响因子：
2.7
通讯作者：
Gul, Zartash
中科院分区：
文献类型：
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作者：
Hilal, Talal;Slone, Stacey;Gul, Zartash
巨细胞病毒（CMV）再激活和复发风险之间的关联尚未评估与T细胞耗竭策略的关系。我们评估了93例接受异基因造血干细胞移植（HSCT）的患者，并分析了T细胞耗竭策略与复发和CMV再激活累积发生率之间的相关性。接受ATG治疗的患者中共有33%与接受Alemtuzumab治疗的患者中有34%发生CMV再激活。CMV再激活患者1年和3年的累积复发率分别为3%和20%，而无CMV再激活患者1年和3年的累积复发率分别为30%和38%（p=0.02）。当单独分析时，这种效应在髓系中持续存在，但在淋巴组中不存在。CMV再激活患者的非复发死亡率（NRM）有增加的数字趋势，尤其是在髓系组。T细胞清除剂的选择和CMV再激活率与不同的总生存率（OS）无关。这些结果表明，T细胞耗竭策略的选择可能对CMV再激活率、疾病复发率和生存率具有相似的影响。在未暴露于体内T细胞耗竭剂的患者中检查这些变量的进一步研究可能是有意义的。(C)2017爱思唯尔有限公司版权所有
The association between cytomegalovirus (CMV) reactivation and relapse risk has not been evaluated in relation to T cell depletion strategies. We evaluated 93 patients who underwent allogeneic hematopoietic stem cell transplantation (HSCT) and analyzed the association between T cell depletion strategies with the cumulative incidence of relapse and CMV reactivation. A total of 33% of patients who received ATG vs. 34% who received alemtuzumab developed CMV reactivation. The cumulative incidence of relapse was 3% at 1year and 20% at 3 years in patients with CMV reactivation vs. 30% at 1year and 38% at 3 years in patients without CMV reactivation (p=0.02). When analyzed separately, this effect persisted in the myeloid, but not the lymphoid group. There was a numerical trend towards increased non-relapse mortality (NRM) in patients with CMV reactivation, especially in the myeloid group. The choice of T cell depleting agent and the rate of CMV reactivation were not associated with different overall survival (OS) rates. These results suggest that the choice of T cell depletion strategy may have similar effects on rates of CMV reactivation, disease relapse, and survival. Further studies examining these variables in patients not exposed to in-vivo T cell depleting agents may be of interest. (C) 2017 Elsevier Ltd. All rights reserved.