Journal
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
Volume 18, Issue 11, Pages 1700-1708Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2012.05.012
Keywords
Human herpesvirus 6; Hematopoietic cell transplantation; Mortality; Cytomegalovirus; Acute graft-versus-host disease
Categories
Funding
- Roche/Genentech
- Chimerix Inc.
- National Institutes of Health [AI057639, CA018029, HL036444, HL94294, CA078902]
Ask authors/readers for more resources
Human herpesvirus 6 (HHV-6) reactivation has been associated with acute graft-versus-host-disease (aGVHD), cytomegalovirus reactivation, and mortality after allogeneic hematopoietic cell transplantation (HCT), but previous studies have yielded inconsistent results. We performed a large prospective study of allogeneic HCT recipients in order to more definitively define the relationships between HHV-6 and these important outcomes. Plasma specimens were collected prospectively from 315 allogeneic HCT recipients and tested for HHV-6 DNA at baseline and twice weekly for 12 weeks. Cox proportional hazards models were used to evaluate the time-dependent associations between HHV-6 reactivation and the targeted outcomes. HHV-6 was detected in 111 of 315 patients (35%) at a median of 20 days after HCT. HHV-6 reactivation was associated with subsequent cytomegalovirus reactivation (adjusted hazard ratio [aHR], 1.9; 95% confidence interval [CI], 1.3-2.8; P = .002). High-level HHV-6 (>1,000 HHV-6 DNA copies/mL) was associated with subsequent grades II to IV aGVHD (aHR, 2.4; 95% CI, 1.60-3.6; P <.001). High-level HHV-6 reactivation was also associated with nonrelapse mortality (aHR, 2.7; 95% CI, 1.2-6.3; P =.02). HHV-6 reactivation was independently and quantitatively associated with increased risk of subsequent cytomegalovirus reactivation, aGVHD, and mortality after HCT. A randomized antiviral trial is warranted to establish causality between HHV-6 and these endpoints and to determine if reducing HHV-6 reactivation will improve outcome after HCT. Biol Blood Marrow Transplant 18: 1700-1708 (2012) (C) 2012 American Society fir Blood and Marrow Transplantation
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available