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Stem Cell Transplantation: Discussion Paper

Early cytomegalovirus infections following allogeneic stem cell transplantation: a comparison between non-malignant and malignant haematological disorders

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Abstract

The haematological indications for allogeneic stem cell transplantation can be broadly divided into non-malignant and malignant disorders. We compared the incidence and risk factors for post-transplant cytomegalovirus (CMV) infections between these two biologically diverse subgroups of haematological conditions. Out of 105 allogeneic transplants, 64 and 41 were for underlying non-malignant and malignant indications respectively. CMV infections were significantly more frequent (P=0·016) in the malignant subgroup. Pre-transplant recipient CMV seropositivity in both subgroups (negative versus positive; non-malignant,P=0·023; malignant, p<0·001), donor seropositivity (P=0·002) and acute graft-versus-host disease (GVHD) (P=0·02) in the non-malignant subgroup and ≥3 courses of previous cytotoxic therapy (P=0·023) in the malignant subgroup were found to be associated with an increased risk of CMV infections. On multivariate analysis, donor seropositivity in the non-malignant patients (negative versus positive,P=0·022; odds ratio: 0·18) and recipient seropositivity in patients with malignancies (negative versus positive; P=0·001, odds ratio: 0·01) were identified to be significant factors for risk of CMV infection.

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