Impact of cytomegalovirus viremia on allogeneic peripheral blood stem cell transplantation in patients with acute leukemia: a single Egyptian center experience

Abstract

Background Hematopoietic stem cell transplantation is now established as a standard therapeutic modality for a variety of malignant and nonmalignant diseases. The first successful allogeneic hematopoietic stem cell transplantation was done with bone marrow as the source of hematopoietic stem cells in 1968.Aim This retrospective study evaluates the impact of cytomegalovirus (CMV) viremia in patients with acute myeloid leukemia and acute lymphoblastic leukemia after allogeneic stem cell transplantation.Patients and methods Patients with acute leukemia (AML and ALL) who underwent allogeneic peripheral blood stem cell transplantation at Nasser Institute, in the time period between 2015 and 2016 (2 years) were included in the study.Results There were 112 patients: 69 men (61.6%) and 43 women (38.4%). Age: mean=30.1±12.04, range 4–58. Overall survival of the CMV positive group is 60% which is lower than that in the CMV negative group which is 69.1% with a statistically insignificant P value of 0.3. Overall survival of CMV positive and acute graft-vs-host disease (aGVHD) patients is 53.8 which is lower than that of CMV negative patients which is 69.6% but it is statistically insignificant (P=0.1). This may be attributed to non-CMV–non-aGVHD-related mortality in acute leukemia (as disease relapse).Conclusion The use of CMV prophylaxis routinely with new agents with lower toxicity, especially in patients at high risk of CMV replication, might reduce the incidence of CMV replications, reducing the morbidity and mortality, and according to some studies may also reduce the incidence of aGVHD and its related morbidity and mortality.