TY - JOUR
T1 - Incidence and impact of community respiratory viral infections in post-transplant cyclophosphamide-based graft-versus-host disease prophylaxis and haploidentical stem cell transplantation
AU - Mulroney, Carolyn M.
AU - Bilal Abid, Muhammad
AU - Bashey, Asad
AU - Chemaly, Roy F.
AU - Ciurea, Stefan O.
AU - Chen, Min
AU - Dandoy, Christopher E.
AU - Diaz Perez, Miguel A.
AU - Friend, Brian D.
AU - Fuchs, Ephraim
AU - Ganguly, Siddhartha
AU - Goldsmith, Scott R.
AU - Kanakry, Christopher G.
AU - Kim, Soyoung
AU - Komanduri, Krishna V.
AU - Krem, Maxwell M.
AU - Lazarus, Hillard M.
AU - Ljungman, Per
AU - Maziarz, Richard
AU - Nishihori, Taiga
AU - Patel, Sagar S.
AU - Perales, Miguel Angel
AU - Romee, Rizwan
AU - Singh, Anurag K.
AU - Reid Wingard, John
AU - Yared, Jean
AU - Riches, Marcie
AU - Taplitz, Randy
N1 - Publisher Copyright:
© 2021 British Society for Haematology and John Wiley & Sons Ltd
PY - 2021/7
Y1 - 2021/7
N2 - Community respiratory viral infections (CRVIs) are associated with pulmonary function impairment, alloimmune lung syndromes and inferior survival in human leucocyte antigen (HLA)-matched allogeneic haematopoietic stem cell transplant (HCT) recipients. Although the incidence of viral infections in HLA-haploidentical HCT recipients who receive post-transplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis is reportedly increased, there are insufficient data describing the incidence of CRVIs and the impact of donor source and PTCy on transplant outcomes. Analysing patients receiving their first HCT between 2012 and 2017 for acute myeloid leukaemia, acute lymphoblastic leukaemia and myelodysplastic syndromes, we describe comparative outcomes between matched sibling transplants receiving either calcineurin-based GVHD prophylaxis (SibCNI, N = 1605) or PTCy (SibCy, N = 403), and related haploidentical transplants receiving PTCy (HaploCy, N = 757). The incidence of CRVIs was higher for patients receiving PTCy, regardless of donor type. Patients in the HaploCy cohort who developed a CRVI by day +180 had both a higher risk of treatment-related mortality [hazard ratio (HR) 2⋅14, 99% confidence interval (CI) 1⋅13–4⋅07; P = 0⋅002] and inferior 2-year overall survival (HR 1⋅65, 99% CI 1⋅11–2⋅43; P = 0⋅001) compared to SibCNI with no CRVI. This finding justifies further research into long-term antiviral immune recovery, as well as development of preventive and treatment strategies to improve long-term outcomes in such patients.
AB - Community respiratory viral infections (CRVIs) are associated with pulmonary function impairment, alloimmune lung syndromes and inferior survival in human leucocyte antigen (HLA)-matched allogeneic haematopoietic stem cell transplant (HCT) recipients. Although the incidence of viral infections in HLA-haploidentical HCT recipients who receive post-transplant cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis is reportedly increased, there are insufficient data describing the incidence of CRVIs and the impact of donor source and PTCy on transplant outcomes. Analysing patients receiving their first HCT between 2012 and 2017 for acute myeloid leukaemia, acute lymphoblastic leukaemia and myelodysplastic syndromes, we describe comparative outcomes between matched sibling transplants receiving either calcineurin-based GVHD prophylaxis (SibCNI, N = 1605) or PTCy (SibCy, N = 403), and related haploidentical transplants receiving PTCy (HaploCy, N = 757). The incidence of CRVIs was higher for patients receiving PTCy, regardless of donor type. Patients in the HaploCy cohort who developed a CRVI by day +180 had both a higher risk of treatment-related mortality [hazard ratio (HR) 2⋅14, 99% confidence interval (CI) 1⋅13–4⋅07; P = 0⋅002] and inferior 2-year overall survival (HR 1⋅65, 99% CI 1⋅11–2⋅43; P = 0⋅001) compared to SibCNI with no CRVI. This finding justifies further research into long-term antiviral immune recovery, as well as development of preventive and treatment strategies to improve long-term outcomes in such patients.
KW - Allogeneic transplant
KW - Post Transplant Cyclophosphamide
KW - Respiratory viral infection
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U2 - 10.1111/bjh.17563
DO - 10.1111/bjh.17563
M3 - Article
C2 - 34124796
AN - SCOPUS:85107820824
SN - 0007-1048
VL - 194
SP - 145
EP - 157
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 1
ER -