Contributions
Abstract: PB2046
Type: Publication Only
Background
HHV6 reactivation is a well characterized phenomenon occurring after allogeneic hematopoietic cell transplantation (HCT). Recently, it has been more often reported after autologous HCT (auto-HCT) and the optimal management is not well established.
Aims
Our objective was to characterize the clinical and biological setting associated with HHV6 reactivation and describe its management.
Methods
We describe here a total of 18 cases of HHV6 reactivations that occurred in patients who received auto-HCT between years 2015 and 2017. There was X (%) males and Y (%) females, the median age at transplantation was 59 years (range: 39-67), diagnosis was lymphoma in majority of cases (N=15, 83%, 6 diffuse large B cell, 3 follicular, 4 mantle cell and 2 T cell), while 3 patients had multiple myeloma (MM). Conditioning regimen was melphalan 200 mg/m² in MM patients and for lymphoma patients it was thiotepa, etoposide, cytarabine melphalan (TEAM), (N=7), BCNU-EAM (BEAM) (N=3), Bendamustin-EAM (N=3) and BCNU-AM (N=2). After transplantation, the median time to neutrophils recovery (neutrophils > 0.5 x 109/L) was 11 days (range: 9-13).
Results
The predominant symptom that justified the detection of HHV6 was the apparition of fever. (in 14 patients, 78%). The other symptoms were isolated pancytopenia for 3 patients (17%), and one patient had an isolated erythema. The symptoms associated with fever were diarrhea for 3 patients, pneumopathy for 2 patients; erythema for 3 and 1 macrophagic activation syndrome. Sixteen patients received intravenous immunoglobulin after HHV6 reactivation. The other 2 patients had a spontaneous resolution of their symptoms. None of the patients required antiviral therapy for the treatment of the HHV6 reactivation. The HHV6 reactivation did not have an impact on engraftment and hematological recovery.
Conclusion
We report a retrospective analysis of 18 cases of HHV6 reactivation following autologous stem cell transplant. The majority of the patients was successfully managed with intravenous immunoglobulin, avoiding therefore the possible toxicities of antiviral therapies.
Session topic: 31. Infectious diseases, supportive care
Abstract: PB2046
Type: Publication Only
Background
HHV6 reactivation is a well characterized phenomenon occurring after allogeneic hematopoietic cell transplantation (HCT). Recently, it has been more often reported after autologous HCT (auto-HCT) and the optimal management is not well established.
Aims
Our objective was to characterize the clinical and biological setting associated with HHV6 reactivation and describe its management.
Methods
We describe here a total of 18 cases of HHV6 reactivations that occurred in patients who received auto-HCT between years 2015 and 2017. There was X (%) males and Y (%) females, the median age at transplantation was 59 years (range: 39-67), diagnosis was lymphoma in majority of cases (N=15, 83%, 6 diffuse large B cell, 3 follicular, 4 mantle cell and 2 T cell), while 3 patients had multiple myeloma (MM). Conditioning regimen was melphalan 200 mg/m² in MM patients and for lymphoma patients it was thiotepa, etoposide, cytarabine melphalan (TEAM), (N=7), BCNU-EAM (BEAM) (N=3), Bendamustin-EAM (N=3) and BCNU-AM (N=2). After transplantation, the median time to neutrophils recovery (neutrophils > 0.5 x 109/L) was 11 days (range: 9-13).
Results
The predominant symptom that justified the detection of HHV6 was the apparition of fever. (in 14 patients, 78%). The other symptoms were isolated pancytopenia for 3 patients (17%), and one patient had an isolated erythema. The symptoms associated with fever were diarrhea for 3 patients, pneumopathy for 2 patients; erythema for 3 and 1 macrophagic activation syndrome. Sixteen patients received intravenous immunoglobulin after HHV6 reactivation. The other 2 patients had a spontaneous resolution of their symptoms. None of the patients required antiviral therapy for the treatment of the HHV6 reactivation. The HHV6 reactivation did not have an impact on engraftment and hematological recovery.
Conclusion
We report a retrospective analysis of 18 cases of HHV6 reactivation following autologous stem cell transplant. The majority of the patients was successfully managed with intravenous immunoglobulin, avoiding therefore the possible toxicities of antiviral therapies.
Session topic: 31. Infectious diseases, supportive care