Incidence of refractory cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation

Fumiaki Jinnouchi, Yasuo Mori, Goichi Yoshimoto, Takuji Yamauchi, Takuya Nunomura, Ayano Yurino, Masayasu Hayashi, Junichiro Yuda, Takahiro Shima, Jun Odawara, Shuichiro Takashima, Kenjiro Kamezaki, Koji Kato, Toshihiro Miyamoto, Koichi Akashi, Katsuto Takenaka

Research output: Contribution to journalArticlepeer-review

Abstract

Post-transplant cytomegalovirus (CMV) disease can be almost completely avoided by current infection control procedures. However, CMV reactivation occurs in more than half of patients, and some patients can develop clinically resistant CMV infections. Whether resistance is due to the host’s immune status or a viral resistance mutation is challenging to confirm. Therefore, a prospective observational analysis of refractory CMV infection was conducted in 199 consecutive patients who received allogeneic hematopoietic stem cell transplantation at a single institution. Among them, 143 (72%) patients received anti-CMV drugs due to CMV reactivation, and only 17 (8.5%) exhibited refractory CMV infection. These patients had clinically refractory infection. However, viral genome analysis revealed that only one patient exhibited a mutation associated with the anti-CMV drug resistance. Clinical resistance was mainly correlated with host immune factors, and the incidence of resistance caused by gene mutations was low at the early stage after a transplantation.

Original languageEnglish
JournalInternational journal of hematology
DOIs
Publication statusAccepted/In press - 2021

All Science Journal Classification (ASJC) codes

  • Hematology

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