Protective Effect of Cytomegalovirus Reactivation on Relapse after Allogeneic Hematopoietic Cell Transplantation in Acute Myeloid Leukemia Patients Is Influenced by Conditioning Regimen

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Abstract

Cytomegalovirus (CMV) reactivation after allogeneic hematopoietic cell transplant (allo-HCT) has been associated with a reduced risk of relapse in patients with acute myeloid leukemia (AML). However, the influence of the conditioning regimen on this protective effect of CMV reactivation after allo-HCT is relatively unexplored. To address this, we evaluated the risk of relapse in 264 AML patients who received T cell-replete, 6/6 HLA matched sibling or 10/10 HLA matched unrelated donor transplantation at a single institution between 2006 and 2011. Of these 264 patients, 206 received myeloablative (MA) and 58 received reduced-intensity conditioning (RIC) regimens. CMV reactivation was observed in 88 patients with MA conditioning and 37 patients with RIC. At a median follow-up of 299days, CMV reactivation was associated with significantly lower risk of relapse in patients who received MA conditioning both in univariate (P=01) and multivariate analyses (hazard ratio, .5246; P=006); however, CMV reactivation did not significantly affect the risk of relapse in our RIC cohort. These results confirm the protective effect of CMV reactivation on relapse in AML patients after allo-HCT reported by previous studies but suggest this protective effect of CMV reactivation on relapse is influenced by the conditioning regimen used with the transplant.

Original languageEnglish
Pages (from-to)46-52
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2014

Keywords

  • Acute myeloid leukemia
  • Allogeneic hematopoietic cell transplantation
  • CMV
  • Myeloablative
  • Reduced intensity
  • Relapse

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