Cytomegalovirus Infection Risk Factors in Allogeneic Hematopoietic Stem Cell Transplantation Can Defibrotide Be a Risk Factor?

Abstract

Introduction and purpose: Cytomegalovirus (CMV) infection is a prevalent complication, affecting 30% to 50% of patients following Allogeneic Hematopoietic Stem Cell Transplantation (allo-AHCT). This study aims to investigate the risk factors contributing to CMV infection development.

Materials and methods: A retrospective analysis was performed on 196 patients with hematological malignancies who underwent allo-HSCT in the Stem Cell Transplantation Unit of Inonu University Faculty of Medicine over a 5-year period. Propensity scores were calculated by matching 1:1 for gender and age variables in individuals with CMV infection and in the control group.

Results: Of the 196 patients included in the study, 75 (38.3 %) were female and 121 (61.7 %) were male. According to univariate analysis, CMV infection was seen more frequently in ALL patients than in AML patients (p = .012), while the conditioning regimen (p = 1) did not affect the outcome in terms of risk. Blood cyclosporine levels measured simultaneously with CMV positivity were significant in terms of risk (p = .006). A significant correlation was found between GvHD and CMV infection (p < .001). According to multivariate analysis, receiving defibrotide for VOD prophylaxis posed a risk for CMV positivity.

Conclusion: In our study, only defibrotide prophylaxis was noted as a risk factor in multivariate analysis. While there are ongoing studies for the use of defibrotide in GVHD prophylaxis, more studies are needed to say that it is a definite risk factor for CMV. We believe that focusing on prophylactic treatments used during the transplantation process will be guiding in determining risk factors.