CMV reactivation is associated with a lower incidence of relapse after allo-SCT for CML

Bone Marrow Transplant. 2013 Oct;48(10):1313-6. doi: 10.1038/bmt.2013.49. Epub 2013 Apr 8.

Abstract

Preemptive therapy at CMV reactivation has diminished post-transplant CMV mortality. Furthermore, recent studies suggest a favorable 'virus-versus-leukemia' effect from reactivating CMV, reducing relapse of AML after SCT. We studied the relationship of CMV reactivation with leukemic relapse in 110 patients with CML receiving HLA-identical sibling SCT between 1993 and 2008. Of these, 79 (72%) were in chronic phase, 5 in second chronic phase, 17 in accelerated phase and 9 in blast phase. A total of 97 patients (88%) received a myeloablative conditioning regimen, 97 received 4-log ex vivo T cell-depleted grafts and 13 received T-replete grafts. CMV reactivation before day 100 was observed in 72 patients (65.5%). At a median follow-up of 6.2 years, CMV reactivation < day 100 as a time-dependent covariate was an independent factor associated with decreased relapse. We conclude that CMV reactivation may contribute to a beneficial GVL effect in CML transplant recipients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cytomegalovirus / physiology*
  • Cytomegalovirus Infections / virology*
  • Female
  • Hematopoietic Stem Cell Transplantation / methods*
  • Humans
  • Incidence
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / virology*
  • Male
  • Middle Aged
  • Recurrence
  • Transplantation Conditioning / methods
  • Transplantation, Homologous
  • Virus Activation
  • Young Adult