Features of Epstein–Barr Virus and Cytomegalovirus Reactivation in Acute Leukemia Patients After Haplo-HCT With Myeloablative ATG-Containing Conditioning Regimen

• DOI: 10.3389/fcimb.2022.865170
• Publication Date: 2022-05-16T07:06:51Z
• Authors: Yuhua Ru; Jinjin Zhu; Tiemei Song; Yiyang Ding; Ziling Zhu; Yi Fan; Yang Xu; Aining Sun; Huiying Qiu; Zhengming Jin; Xiaowen Tang; Yue Han; Chengcheng Fu; Suning Chen; Xiao Ma; Feng Chen; Jia Chen; Depei Wu
• Keywords: Regimen; Cytomegalovirus; Cumulative incidence

Background Haploidentical donor hematopoietic cell transplantation (haplo-HCT) has become a preferred option for patients without HLA-matched donors, but it increases the risk of viral reactivations. Epstein–Barr virus (EBV) and cytomegalovirus (CMV) are common viruses post-HCT, limited data have been reported in setting haplo-HCT. Methods We conducted retrospective study enrolling acute leukemia who received haplo-HCT with myeloablative conditioning regimen employing ATG our center from July 2014 to 2017. All enrolled were EBV-IgM EBV-DNA negative EBV-IgG positive, so their donors. The same went CMV as well. Results In total, 602 recruited consisting 331 myeloid (AML) 271 lymphoblastic (ALL). One-year cumulative incidences EBV (22.9% ± 2.4% vs. 27.4% 2.8%, P = 0.169) (24.7% 29.4% 0.190) reactivation comparable between AML ALL. independent factors each other. group, male recipients [HR 1.275, 95% CI (1.001–1.624), 0.049] graft-versus-host disease 1.592, (1.001–2.533), reactivation, respectively. rather than was related trend worsened treatment-related mortality (TRM) (15.6% 0.1% 10.2% 0.0%, 0.067) progression-free survival (PFS) (60.6% 4.1% 70.3% 2.3%, 0.073), while significant impacts revealed only subgroup analysis. resulted remarkable inferior 2-year overall (OS) (64.2% 5.7% 77.6% 3.2%, 0.038) PFS (55.0% 5.9% 71.9% 3.4%, 0.042) ALL patients. On other hand, EBV+/CMV− subgroup, relapse lower (8.2% 0.2% 32.4% 0.8%, 0.010) compared patients, which led superior OS (82.0% 6.2% 60.3% 8.8%, 0.016) (74.5% 7.0% 57.5% 8.4%, 0.036). Conclusion concluded that reactivations frequent after haplo-HCT, possibly distinctive HCT. There could be potential interaction CMV, on transplant outcomes remained complex.