Ten-year epidemiology and risk factors of cytomegalovirus infection in hematopoietic stem cell transplantation patients in Taiwan

Yi-Che Huang; Fei-Yuan Hsiao; Shang-Ting Guan; Ming Yao; Chia-Jen Liu; Tzu-Ting Chen; Tung-Liang Lin; Yi-Chang Liu; Tsai-Yun Chen; Ying-Chung Hong; Ming-Chun Ma; Tran-Der Tan; Chuan-Cheng Wang; Yi-Ying Wu; Po-Wei Liao; Yi-Feng Wu; Yi-Yang Chen; Yuan-Bin Yu; Yao-Yu Hsieh; Ming-Yang Lee; Jia-Hau Liu; Shu-Wen Lin; Bor-Sheng Ko

Journal of Microbiology, Immunology and Infection (Jun 2024)

Ten-year epidemiology and risk factors of cytomegalovirus infection in hematopoietic stem cell transplantation patients in Taiwan

Yi-Che Huang,
Fei-Yuan Hsiao,
Shang-Ting Guan,
Ming Yao,
Chia-Jen Liu,
Tzu-Ting Chen,
Tung-Liang Lin,
Yi-Chang Liu,
Tsai-Yun Chen,
Ying-Chung Hong,
Ming-Chun Ma,
Tran-Der Tan,
Chuan-Cheng Wang,
Yi-Ying Wu,
Po-Wei Liao,
Yi-Feng Wu,
Yi-Yang Chen,
Yuan-Bin Yu,
Yao-Yu Hsieh,
Ming-Yang Lee,
Jia-Hau Liu,
Shu-Wen Lin,
Bor-Sheng Ko

Affiliations

Yi-Che Huang: Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, Taipei Medical University, Shuang Ho Hospital, New Taipei City, Taiwan
Fei-Yuan Hsiao: Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
Shang-Ting Guan: Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Health Data Research Center, National Taiwan University, Taipei, Taiwan
Ming Yao: Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Chia-Jen Liu: Division of Hematology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan
Tzu-Ting Chen: Division of Hematology and Oncology, China Medical University Hospital, Taiwan
Tung-Liang Lin: Division of Hematology, Chang Gung Memorial Hospital, Linkou, Taiwan
Yi-Chang Liu: Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan
Tsai-Yun Chen: Division of Hematology, Department of Internal Medicine, National Cheng Kung University Hospital, Taiwan
Ying-Chung Hong: Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
Ming-Chun Ma: Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
Tran-Der Tan: Department of Hematopoietic Stem Cell Transplantation and Cell Therapy, Koo Foundation Sun Yat-Sen Cancer Center, Taiwan
Chuan-Cheng Wang: Division of Hematology-Oncology, Changhua Christian Hospital, Taiwan
Yi-Ying Wu: Division of Hematology/Oncology, Tri-Service General Hospital, National Defense Medical Center, Taiwan
Po-Wei Liao: Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taiwan
Yi-Feng Wu: Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Hualien, Taiwan
Yi-Yang Chen: Division of Hematology and Oncology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
Yuan-Bin Yu: Division of Oncology-Hematology, Far Eastern Memorial Hospital, Taiwan
Yao-Yu Hsieh: Department of Hematology and Oncology, Taipei Medical University, Shuang Ho Hospital, Taiwan
Ming-Yang Lee: Division of Hematology and Oncology, Department of Internal Medicine, Chia-Yi Christian Hospital, Taiwan
Jia-Hau Liu: Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
Shu-Wen Lin: Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Cancer Center, Taipei, Taiwan; Corresponding author. Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Bor-Sheng Ko: Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taiwan; School of Medicine, College of Medicine, National Taiwan University, Taiwan; Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, College of Medicine, Taipei, Taiwan.

Journal volume & issue: Vol. 57, no. 3
pp. 365 – 374

Abstract

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Background: Cytomegalovirus (CMV) can cause infection and critical diseases in hematopoietic stem cell transplantation (HSCT) recipients. This study aimed to explore the cumulative incidence and risk factors for CMV infection and disease among HSCT recipients in Taiwan. Methods: This retrospective cohort study using the Taiwan Blood and Marrow Transplantation Registry (TBMTR) included HSCT recipients between 2009 and 2018 in Taiwan. The primary outcome was cumulative incidence of CMV infection or disease at day 100 after HSCT. Secondary outcomes included day 180 cumulative incidence of CMV infection or disease, infection sites, risk factors for CMV infection or disease, survival analysis, and overall survival after CMV infection and disease. Results: There were 4394 HSCT recipients included in the study (2044 auto-HSCT and 2350 allo-HSCT). The cumulative incidence of CMV infection and disease was significantly higher in allo-HSCT than in auto-HSCT patients at day 100 (53.7% vs. 6.0%, P < 0.0001 and 6.1% vs. 0.9%, P < 0.0001). Use of ATG (HR 1.819, p < 0.0001), recipient CMV serostatus positive (HR 2.631, p < 0.0001) and acute GVHD grades ≥ II (HR 1.563, p < 0.0001) were risk factors for CMV infection, while matched donor (HR 0.856, p = 0.0180) and myeloablative conditioning (MAC) (HR 0.674, p < 0.0001) were protective factors. Conclusion: The study revealed a significant disparity in terms of the incidence, risk factors, and clinical outcomes of CMV infection and disease between auto and allo-HSCT patients. These findings underscore the importance of considering these factors in the management of HSCT recipients to improve outcomes related to CMV infections.

Published in Journal of Microbiology, Immunology and Infection

ISSN: 1684-1182 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Science: Microbiology
Website: https://www.sciencedirect.com/journal/journal-of-microbiology-immunology-and-infection

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