Human Herpesvirus 6 DNAemia Is Associated With Worse Survival After Ex Vivo T-Cell-Depleted Hematopoietic Cell Transplant

TY - JOUR

T1 - Human Herpesvirus 6 DNAemia Is Associated With Worse Survival After Ex Vivo T-Cell-Depleted Hematopoietic Cell Transplant

AU - Lee, Yeon Joo

AU - Su, Yiqi

AU - Cho, Christina

AU - Tamari, Roni

AU - Perales, Miguel Angel

AU - Jakubowski, Ann A.

AU - Papanicolaou, Genovefa A.

N1 - Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

PY - 2022/2/1

Y1 - 2022/2/1

N2 - Background: We examined the correlation between persistent human herpesvirus 6 (HHV-6) DNAemia (p-HHV-6) and absolute lymphocyte count (ALC), platelet count (PLT), and all-cause mortality by 1 year after ex vivo T-cell-depleted (TCD) hematopoietic cell transplant (HCT). Methods: We analyzed a cohort of adult TCD HCT recipients during 2012-2016 prospectively monitored for plasma HHV-6 by quantitative polymerase chain reaction from day +14 post-HCT through day +100 (D+100). p-HHV-6 was defined as ≥2 consecutive values of ≥500 copies/mL by D+100. PLT and ALC were compared between patients with and without p-HHV-6 using generalized estimating equations (GEE). Multivariable Cox proportional hazard models (PH) were used to identify the impact of p-HHV-6 on 1 year mortality. Results: Of 312 patients, 83 (27%) had p-HHV-6 by D+100. p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. In multivariable models, p-HHV-6 was associated with higher mortality by 1 year post-HCT (adjusted hazard ratio, 2.97 [95% confidence interval, 1.62-5.47]; P =. 0005), after adjusting for age, antiviral treatment, and ALC at D+100. Conclusions: p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. p-HHV-6 was an independent predictor of mortality in the first year after TCD HCT.

AB - Background: We examined the correlation between persistent human herpesvirus 6 (HHV-6) DNAemia (p-HHV-6) and absolute lymphocyte count (ALC), platelet count (PLT), and all-cause mortality by 1 year after ex vivo T-cell-depleted (TCD) hematopoietic cell transplant (HCT). Methods: We analyzed a cohort of adult TCD HCT recipients during 2012-2016 prospectively monitored for plasma HHV-6 by quantitative polymerase chain reaction from day +14 post-HCT through day +100 (D+100). p-HHV-6 was defined as ≥2 consecutive values of ≥500 copies/mL by D+100. PLT and ALC were compared between patients with and without p-HHV-6 using generalized estimating equations (GEE). Multivariable Cox proportional hazard models (PH) were used to identify the impact of p-HHV-6 on 1 year mortality. Results: Of 312 patients, 83 (27%) had p-HHV-6 by D+100. p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. In multivariable models, p-HHV-6 was associated with higher mortality by 1 year post-HCT (adjusted hazard ratio, 2.97 [95% confidence interval, 1.62-5.47]; P =. 0005), after adjusting for age, antiviral treatment, and ALC at D+100. Conclusions: p-HHV-6 was associated with lower ALC and PLT in the first year post-HCT. p-HHV-6 was an independent predictor of mortality in the first year after TCD HCT.

KW - T-cell depletion

KW - hematopoietic cell transplant

KW - human herpesvirus 6

KW - mortality

UR - https://www.scopus.com/pages/publications/85123968806

U2 - 10.1093/infdis/jiab412

DO - 10.1093/infdis/jiab412

M3 - Article

C2 - 34390240

SN - 0022-1899

VL - 225

SP - 453

EP - 464

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 3

ER -