Efficacy and Safety of Aqueous Interleukin-8-Guided Treatment in Cytomegalovirus Retinitis after Bone Marrow Hematopoietic Stem Cell Transplantation

ABSTRACT

Purpose

To explore the optimal treatment for cytomegalovirus retinitis (CMVR) in patients status-post Allogeneic bone marrow hematopoietic stem cell transplantation (Allo-HSCT), based on aqueous humor indicators.

Methods

A randomized controlled study with 35 eyes. Eyes were randomized with a 1:1 ratio to standard treatment group (Group 1, with treatment endpoint as aqueous CMV-DNA load＜10³ copy/ml), and interleukin (IL)-8 group (Group 2, with treatment endpoint as aqueous IL-8 level ＜30 pg/ml or CMV-DNA load＜10³ copy/ml) to receive antiviral intravitreal injections. Number of injections, CMVR recurrence rate, complication rate, and vision changes were analyzed and compared.

Results

The mean number of injections in group 2 was less than in group 1 (6 vs 8 respectively, p<0.05). There were no significant differences in CMVR recurrence, complication and vision recovery rate.

Conclusion

Incorporating aqueous humor IL-8 level into the criteria of CMVR treatment decision can safely and effectively reduce the number of intravitreal injections needed and can be used as important indicators to assess treatment endpoint.

KEYWORDS:

• Allogeneic bone marrow hematopoietic stem cell transplantation (Allo-HSCT)
• aqueous humor
• Interleukin-8 (IL-8)
• cytomegalovirus retinitis (CMVR)
• treatment

Acknowledgments

This work was supported by grants from National Natural Science Foundation of China under Grant (81800847); the tenth “Academic Star” of Peking University People’s Hospital Grant (RS2018-05); Technological Innovation and Cultivation Fund for medical youth of Peking University, (BMU2020PYB014). The authors would like to thank Qingyu Meng for excellent technical support and Juan Chen for warmly mental support.

Author Contributions

ZC, MH, and HJ designed the study. ZC, MH, and HJ collected the data. ZC, MH, and HJ analyzed and interpreted the results. WE was not involved in data collection and statistics. ZC wrote the manuscript. ZC, HJ, and WE edited and revised the manuscript, and all authors approved the final version of the manuscript.

Availability of Data and Material

All data are fully available without restriction.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Consent for Publication

Written informed consent for publication was obtained from all participants.

Disclosure Statement

No Conflicts of Interest.

All authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licencing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Additional information

Funding

This work was supported by grants from National Natural Science Foundation of China under Grant [81800847]; the tenth “Academic Star” of Peking University People’s Hospital Grant [RS2018-05]; Peking University Medicine Fund of Fostering Young Scholars’ Scientific & Technological Innovation supported by “the Fundamental Research Funds for the Central Universities” [BMU2020PYB014].