The association of conditioning regimen with cytomegalovirus reactivation after allogeneic hematopoietic stem cell transplantation

  • Masoud Mardani ORCID Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medial Sciences, Tehran, Iran
  • Sara Abolghasemi ORCID Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medial Sciences, Tehran, Iran
  • Shiva Shabani Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medial Sciences, Tehran, Iran
  • Farzaneh Tavakoli Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
  • Anahita Saeedi Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
  • Sayeh Parkhideh ORCID Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
  • Abbas Hajifathali ORCID Mail Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Science, Tehran, Iran
Keywords:
Cytomegalovirus;, Hematopoietic stem cell transplantation;, Conditioning regimen

Abstract

Background and Objectives: Infections is yet one of the life-threatening complications of the hematopoietic stem cell transplantation (HSCT). The myeloablative and immunosuppressive conditioning regimens, which are administered before HSCT, dampen the defense capacity of the recipients’ immune systems. In this condition, opportunistic infections, especially viral infections such as cytomegalovirus (CMV) can be reactivated and cause morbidity and mortality in HSCT patients. Here, we aimed to find out any possible relationship between types of conditioning regimen and CMV reactivation in allogeneic HSCT patients.
Materials and Methods: We retrospectively analyzed the data of 145 CMV-seropositive cases out of total 201 allo-HSCT patients, including age, gender, underlying disease, conditioning regimen, prophylaxis regimen and occurrence of acute graft-versus-host disease (aGVHD) to evaluate their roles in CMV reactivation.
Results: Our result showed that conditioning regimen containing Busulfan and Fludarabine (P=0.003) or Cyclophosphamide (P=0.02) significantly decrease the early CMV reactivation. Patients who developed aGVHD (P=0.003) and those who received anti-thymocyte globulin (ATG) as prophylaxis regimen (P=0.002), had 1.84 and 2.63 times higher risks of CMV reactivation, respectively.
Conclusion: Our findings suggest the conditioning regimen, aGVHD and ATG as influencing factors for early CMV reactivation post-HSCT which should be considered in the future studies.

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Published
2020-12-16
How to Cite
1.
Mardani M, Abolghasemi S, Shabani S, Tavakoli F, Saeedi A, Parkhideh S, Hajifathali A. The association of conditioning regimen with cytomegalovirus reactivation after allogeneic hematopoietic stem cell transplantation. Iran J Microbiol. 12(6):636-643.
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