Human herpesvirus 6 infection after autologous stem cell transplantation: A multicenter prospective study in adult patients - 01/06/19
, Sylvie Pillet c, Emmanuelle Tavernier a, Victoria Cacheux d, Vanessa Escuret e, Cécile Moluçon-Chabrot d, Karine Augeul-Meunier a, Audrey Mirand f, Christel Regagnon f, Fabien Tinquaut g, Véronique Bousser g, Mathieu Oriol g, Denis Guyotat a, Gilles Salles b, Jacques-Olivier Bay e, Bruno Pozzetto c, Jérôme Cornillon aHighlights |
• | Active HHV-6 infection occurred in 11.2% of autologous stem cell recipients. |
• | HHV-6 infection is associated with delayed neutrophils and platelets recoveries. |
• | HHV-6 infection is associated to increased frequency of non-infectious complications. |
• | Non-infectious complications are more severe when associated to HHV-6 infection. |
Summary |
Objectives |
to prospectively evaluate the incidence and the clinical relevance on hematopoietic reconstitution of HHV-6 infection in autologous hematopoietic stem cell transplantation (ASCT) recipients.
Methods |
HHV-6 DNA load was measured in whole blood specimens once during the 7 days before stem cell re-infusion and once a week after transplantation until hematopoietic recovery. Active HHV-6 infection was defined by 2 consecutive positive DNA loads.
Results |
from July 2012 to February 2015, 196 adult patients undergoing ASCT were enrolled. Twenty-two (11.2%) patients developed active HHV-6 infection with a cumulative incidence of 19% at 40 days after transplantation. The onset of active HHV-6 infection occurred with a median of 13 days after stem cell re-infusion. HHV-6 infection was associated with an increased frequency of non-infectious complications (OR = 5.05; 95%CI 1.78–14.32; P < 0.001). Moreover, the severity of these non-infectious complications was higher in recipients exhibiting HHV-6 infection (OR = 4.62; 95%CI 1.32–16.2; p < 0.01). Delayed neutrophils 10 (IQR: 8–14) vs 8 (IQR: 6–11) days and platelets recoveries 15 (IQR: 11.8–18.5) vs 8 (IQR: 4–14) days were observed in patients with active HHV-6 infection compared to non-infected ones.
Conclusions |
in this study, 11.2% ASCT recipients presented active HHV-6 infection associated with significantly delayed hematologic reconstitution.
Le texte complet de cet article est disponible en PDF.Keywords : HHV-6, Autologous stem cell transplantation, Early infection, Thrombocytopenia, Neutropenia
Plan
Vol 79 - N° 1
P. 36-42 - juillet 2019 Retour au numéro
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