Frontiers in Microbiology (Jun 2024)
Reactivation of cytomegalovirus and bloodstream infection and its impact on early survival after allogeneic haematopoietic stem cell transplantation: a multicentre retrospective study
- Jinhua Ren,
- Jinhua Ren,
- Jinhua Ren,
- Jinhua Ren,
- Jingjing Xu,
- Jingjing Xu,
- Jingjing Xu,
- Jiaqi Sun,
- Jiaqi Sun,
- Jiaqi Sun,
- Jiaqi Sun,
- Xueqiong Wu,
- Xueqiong Wu,
- Xueqiong Wu,
- Xiaozhu Yang,
- Xiaozhu Yang,
- Xiaozhu Yang,
- Chengjun Nie,
- Chengjun Nie,
- Lingqiong Lan,
- Lingqiong Lan,
- Yanling Zeng,
- Yanling Zeng,
- Xiaoyun Zheng,
- Xiaoyun Zheng,
- Xiaoyun Zheng,
- Jing Li,
- Jing Li,
- Jing Li,
- Qiaoxian Lin,
- Qiaoxian Lin,
- Qiaoxian Lin,
- Jianda Hu,
- Jianda Hu,
- Jianda Hu,
- Ting Yang,
- Ting Yang,
- Ting Yang,
- Ting Yang,
- Ting Yang
Affiliations
- Jinhua Ren
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jinhua Ren
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jinhua Ren
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Jinhua Ren
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
- Jingjing Xu
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jingjing Xu
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jingjing Xu
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Jiaqi Sun
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jiaqi Sun
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jiaqi Sun
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Jiaqi Sun
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
- Xueqiong Wu
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Xueqiong Wu
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Xueqiong Wu
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Xiaozhu Yang
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Xiaozhu Yang
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Xiaozhu Yang
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Chengjun Nie
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Chengjun Nie
- Department of Hematology, Ningde Hospital Affiliated to Ningde Normal University, Ningde, China
- Lingqiong Lan
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Lingqiong Lan
- Department of Hematology, The Second Hospital of Longyan, Longyan, China
- Yanling Zeng
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Yanling Zeng
- Department of Hematology, Affiliated Nanping First Hospital of Fujian Medical University, Nanping, China
- Xiaoyun Zheng
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Xiaoyun Zheng
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Xiaoyun Zheng
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Jing Li
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jing Li
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Jing Li
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Qiaoxian Lin
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Qiaoxian Lin
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Qiaoxian Lin
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Jianda Hu
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Jianda Hu
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
- Jianda Hu
- The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
- Ting Yang
- Department of Hematology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Ting Yang
- Department of Hematology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
- Ting Yang
- Institute of Precision Medicine, Fujian Medical University, Fuzhou, China
- Ting Yang
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, China
- Ting Yang
- The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
- DOI
- https://doi.org/10.3389/fmicb.2024.1405652
- Journal volume & issue
-
Vol. 15
Abstract
Cytomegalovirus reactivation (CMVr) and bloodstream infections (BSI) are the most common infectious complications in patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT). Both are associated with great high morbidity whilst the BSI is the leading cause of mortality. This retrospective study evaluated the incidence of CMVr and BSI, identified associated risk factors, assessed their impact on survival in allo-HSCT recipients during the first 100 days after transplantation. The study comprised 500 allo-HSCT recipients who were CMV DNA-negative and CMV IgG-positive before allo-HSCT. Amongst them, 400 developed CMVr and 75 experienced BSI within 100 days after allo-HSCT. Multivariate regression revealed that graft failure and acute graft-versus-host disease were significant risk factors for poor prognosis, whereas CMVr or BSI alone were not. Amongst all 500 patients, 56 (14%) developed both CMVr and BSI in the 100 days after HSCT, showing significantly reduced 6-month overall survival (p = 0.003) and long-term survival (p = 0.002). Specifically, in the initial post-transplant phase (within 60 days), BSI significantly elevate mortality risk, However, patients who survive BSI during this critical period subsequently experience a lower mortality risk. Nevertheless, the presence of CMVr in patients with BSI considerably diminishes their long-term survival prospects. This study provides real-world data on the impact of CMVr and BSI following transplantation on survival, particularly in regions such as China, where the prevalence of CMV IgG-positivity is high. The findings underscore the necessity for devising and executing focused prevention and early management strategies for CMVr and BSI to enhance outcomes for allo-HSCT recipients.
Keywords
- allogeneic haematopoietic stem cell transplantation
- cytomegalovirus reactivation
- bloodstream infection
- haematological disease
- acute myeloid leukaemia