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ctt-journal > Shiryev et al. (Abstract)

Shiryev et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract72

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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The impact of donor CMV-serostatus on the outcome of allogeneic hematopoietic stem cell transplantation in children and adolescents with acute leukemia

Sergey N. Shiryev, Vladimir N. Vavilov, Ildar M. Barkhatov, Natalya V. Stancheva, Alexei B. Chuklovin, Ludmila S. Zubarovskaya

R.M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, St. Petersburg, Russia

Correspondence: Sergey N. Shiryev, R. M. Gorbacheva Memorial Institute of Children Hematology and Transplantation, St. Petersburg Pavlov State Medical University, 6/8 Tolstoy str., St. Petersburg, Russia. E-mail: ftk9@spam is badyandex.ru

Abstract

The aim of the study was to evaluate the impact of donor CMV-serostatus on the post-transplant course and outcome in pediatric and adolescent patients with acute leukemia receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Patients and methods: Fifty-eight recipients of allo-HSCT (either from related or unrelated donors) aged 1–21 years were included in the study. In groups of CMV-positive patients receiving allo-HSCT from CMV-positive (CMV-pos/CMV-pos group) and CMV-negative unrelated donors (CMV-pos/CMV-neg group), the following outcomes were estimated: overall survival (OS), event-free survival (EFS), risk of relapse (RR), transplant-related mortality risk (TRM risk), risk of lethal aGVHD, and risk of CMV reactivation. Also, the same endpoints were compared in all serogroups (recipient/donor): CMV-neg/CMV-neg, CMV-neg/CMV-pos, CMV-pos/CMV-neg, and CMV-pos/CMV-pos groups.

Results: In comparing the recipient/donor CMV-pos/CMV-neg vs. CMV-pos/CMV-pos groups receiving allo-HSCT from unrelated donor, the risk of CMV reactivation was 91.6% vs. 86%; and for aGvHD, 69% vs. 54% respectively (p=NS). The risk of lethal aGVHD was 23% vs. 5% (p=0.03). TRM risk and RR were higher in the CMV-pos/CMV-neg group (65% vs. 38%, p=NS and 48% vs. 10% p=0.04, respectively). Comparing 100 day outcomes after allo-HSCT of the four serogroups (recipient/donor): the highest OS and EFS were in the CMV-neg/CMV-neg group with 80% and 80% respectively, and the lowest OS and EFS rates were in the CMV-pos/CMV-neg group, with 66% and 54% respectively (p=NS). The highest TRM risk was in the CMV-neg/CMV-pos group at 29%; the lowest was in the CMV-pos/CMV-pos group, at 14% (p=NS).

Conclusions: Donor CMV-serostatus has an impact on the outcome of allo-HSCT in children and adolescents with acute leukemia.

Keywords: cytomegalovirus, hematopoietic stem cell transplantation, outcome, children, acute leukemia