Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients.
Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients.
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DOI：
10.1093/ofid/ofab639
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发表时间：
2022-03
影响因子：
4.2
通讯作者：
Kelly MS
中科院分区：
文献类型：
--
作者：
Heston SM;Young RR;Tanaka JS;Jenkins K;Vinesett R;Saccoccio FM;Martin PL;Chao NJ;Kelly MS
Cytomegalovirus (CMV) causes substantial morbidity and mortality after hematopoietic stem cell transplantation (HSCT). There are limited data on risk factors for CMV viremia and the safety of antiviral medications used to treat CMV in children. We conducted a single-center retrospective study of children who underwent HSCT between 2000 and 2016. We used log-logistic regression to evaluate associations between clinical characteristics and CMV-free survival at 100 days after HSCT. We compared the incidences of laboratory-defined adverse events (AEs) during treatment with ganciclovir and foscarnet. Among 969 children, the median (interquartile range) age was 6.5 (3.1–11.5) years, and 80% underwent allogeneic HSCT. Two hundred forty-four (25%) children developed CMV viremia. Older age (odds ratio [OR], 0.95; 95% CI, 0.92–0.98), male sex (OR, 0.71; 95% CI, 0.51–0.99), non-Black, non-White race (OR, 0.56; 95% CI, 0.36–0.87), umbilical cord blood donor source (OR, 0.28; 95% CI, 0.08–0.97), and CMV seropositivity (R-/D+: OR, 0.17; 95% CI, 0.07–0.41; R+/D-: OR, 0.14; 95% CI, 0.09–0.21; R+/D+: OR, 0.08; 95% CI, 0.04–0.15) were associated with lower odds of 100-day CMV-free survival. Compared with foscarnet, ganciclovir was associated with lower incidences of thrombocytopenia (incidence rate ratio [IRR], 0.38; 95% CI, 0.15–0.97), electrolyte AEs (IRR, 0.42; 95% CI, 0.24–0.75), endocrine AEs (IRR, 0.52; 95% CI, 0.34–0.79), and renal AEs (IRR, 0.36; 95% CI, 0.19–0.65). CMV viremia occurred commonly among children after HSCT, and ganciclovir and foscarnet were associated with distinct toxicity profiles among children with CMV infection. These findings should be considered when developing CMV prevention and treatment strategies for children after HSCT. D/C/F/TAF is the reference for combination therapy based on protease inhibitors but has not been compared with regimens containing integrase inhibitors as initial ART. We could not demonstrate D/C/F/TAF noninferiority relative to DTG/ABC/3TC, although both regimens were similarly well tolerated.
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影响因子：
--
作者：
HEINEMANN, MH
通讯作者：
HEINEMANN, MH
DOI：
10.1097/01.mph.0000174242.80167.9d
发表时间：
2005-08-01
影响因子：
1.2
作者：
Patel, SR;Ridwan, RU;Ortín, M
通讯作者：
Ortín, M
影响因子：
1.6
作者：
Jaing, Tang-Her;Chang, Tsung-Yen;Tsay, Pei-Kwei
通讯作者：
Tsay, Pei-Kwei
影响因子：
3.2
作者：
Bejanyan N;Vlasova-St Louis I;Mohei H;Cao Q;El Jurdi N;Wagner JE;Miller JS;Brunstein CG
通讯作者：
Brunstein CG
影响因子：
5.1
作者：
Kimberlin, DW;Lin, CY;Whitley, RJ
通讯作者：
Whitley, RJ