IMPACT OF CYTOMEGALOVIRUS REACTIVATION ON RELAPSE RATE AFTER ALLOGENEIC STEM CELL TRANSPLANTATION IN PATIENTS WITH ACUTE MYELOBLASTIC LEUKEMIA
Author(s): ,
Nour Ben Abdeljelil
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Maroua Ben Hmida
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Rihab Ouerghi
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Amel Lakhal
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Rym El Fatmi
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Lamia Torjemane
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Dorra Belloumi
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Saloua Ladeb
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
,
Wafa Achour
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
Tarek Ben Othman
Affiliations:
Centre National de Greffe de Moelle Osseuse de Tunis,Tunis,Tunisia
EHA Library. ben abdeljelil N. Jun 15, 2019; 266670; PS1053
Dr. Nour ben abdeljelil
Dr. Nour ben abdeljelil
Contributions
Abstract

Abstract: PS1053

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Cytomegalovirus (CMV) infection is a major complication after allogeneic stem cell transplantation (ASCT).

Aims

The aim of the study was to evaluate the impact of CMV reactivation on the relapse rate after ASCT in patients with acute myeloid leukemia (AML).

Methods

Retrospective study conducted in patients with AML who underwent ASCT from HLA identical sibling donor between January 2011 and December 2018. Conditioning regimen consisted of Busulfex and Cyclophosphamide (Bu/Cy) or Fludarabine and Busulfex (F/Bu). Graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and a short course of methotrexate. Antiviral prophylaxis for CMV infection was assured by Acyclovir from day +1 to day +180. CMV detection was carried out once-a-week from engraftment to day +100 by either pp 65 antigenemia test or real-time quantitative PCR.

Results

Ninety-three patients were enrolled (55 men and 38 women). Median age was 33 years (range, 5 - 49 y). At the time of transplant, 73 patients (78.5%) were in CR1, 16 patients (17.2%) were in CR2 and 4 patients (4.3%) were in response failure. CMV serostatus for donor  (D)  and recipient (R) was available for  44 cases (47.3%). Serostatus of R+/D+ and R+/D− was observed in  38  patients (86.4%). Stem cell source were BM in 49 cases (52.7%) and PBSC in 44 cases (47.3%). No graft failure was observed. Acute GVHD grade II-IV occurred in 19 patients (20.4%). Chronic GVHD was observed in 40 patients (45.4%). Twenty-nine patients (31.2%) developed CMV reactivation. With a median follow-up of 2 years (range 49 days – 7 years), the overall survival (OS) and the non-relapse mortality (NRM) were not statistically significant between patients with CMV reactivation and those without CMV reactivation (74% vs 63%, p=0.3 and 20.7% vs 7.8%, p=0.08, respectively). Twenty-four patients (25.8%) relapsed at a median of 6 months (range 2 - 67 months). the rate of relapse among patients with CMV reactivation was significantly lower than in those without CMV reactivation (10.3% vs 32.8%, p =0.02). In univariate analysis, the CMV reactivation was the only factor associated with a decreased risk of relapse (OR= 0.23, 95% CI: 0.06-0.87, p=0.02).

Conclusion

CMV reactivation was associated with decreased relapse risk after ASCT for patients with AML without a benefit in OS.

Session topic: 4. Acute myeloid leukemia - Clinical

Keyword(s): Acute myeloid leukemia, Allogeneic stem cell transplant, CMV infection, Relapse

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