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1.
Current research status of cytomegalovirus infection after hematopoietic stem cell transplantation: a bibliometric analysis
Chen, P., Du, Z., Qiu, S., Wang, H., Zhang, J., Liu, D.
Annals of palliative medicine. 2021;10(9):9614-9626
Abstract
BACKGROUND Hematopoietic stem cell transplantation (HSCT) is an effective method for the treatment of hematological malignancies, severe aplastic anemia, and myelodysplastic syndromes. The most common infectious complication after HSCT is cytomegalovirus (CMV) infection. The purpose of this study was to analyze the status of research related to CMV infection after HSCT by conducting a literature search for CMV, hematopoietic, and stem cell transplantation. METHODS The Science Citation Index Expanded (SCI-E) database in the Web of Science Core Collection (WOSCC) was used as the target database for our literature search. The subject search terms were CMV, hematopoietic, and stem cell transplantation, with the logical operation 'AND'. The search date range was from 1900 to June 15, 2021. We used CiteSpace software to analyze the literature. The analysis included: the annual change in the number of publications, the annual change in the number of references cited, the distribution of countries, the distribution of institutions, the distribution of journals, the distribution of authors, and the use of keywords. RESULTS A total of 1,476 relevant documents were retrieved. The top 5 countries for number of publications were the United States, Germany, Japan, China, and Italy, while the top 5 countries for centrality scores were the United States, Australia, Germany, France, and Italy. The top 5 institutions for the number of publications were: Fred Hutchinson Cancer Research Center, the University of Washington, the University of Minnesota, Karolinska Institute, and Peking University. The top 4 institutions for centrality scores were: Fred Hutchinson Cancer Research Center, Henri-Mondor Hospital, the National Cancer Center, Karolinska University Hospital, and the University of Pavia. There were only 4 authors with a centrality score of 0.01. The literature was mainly published in top hematology journals and journals for immunization and transplantation. The top 5 keywords used were: cytomegalovirus, bone marrow transplantation, recipient, infection, and versus host disease. CONCLUSIONS We found that CMV infection after HSCT has been attracting more and more attention by researchers, and that treatment has been the focus of current research.
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2.
ELISPOT assay of interferon gamma secretion for evaluate human cytomegalovirus reactivation risk in allo-HSCT recipients
Liang, H., Xia, J., Zhang, R., Yang, B., Wu, J., Gui, G., Huang, Y., Chen, X., Yang, R., Wang, H., et al
Journal of medical virology. 2021
Abstract
Human cytomegalovirus (HCMV) is a common cause of significant morbidity and mortality in transplant recipients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We evaluated IFN-? secretion by HCMV NLV-specific CD8+T cells in HCMV-reactivated allo-HSCT recipients using an enzyme-linked immunospot (ELISPOT) assay at 3 months post-transplantation. Blood samples from 47 recipients were tested for HCMV DNAemia, HCMV pp65 antigenemia, and anti-HCMV immunoglobulins (IgG/IgM) during 3 months post-transplantation. Of the 47 transplant recipients, 26 were HLA-A*02-positive and 21 were HLA-A*02-negative. The results were essentially consistent between the 47 transplant recipients and the HLA-A*02-positive recipients. HCMV DNAemia was not linearly correlated with IFN-? spot-forming cells (SFCs) counts; IFN-? SFCs counts did not differ significantly between the HCMV DNAemia-positive and -negative groups, whereas the HCMV-DNA virus loads were inversely correlated with the IFN-? SFCs counts. HCMV pp65 antigenemia was not linearly correlated with IFN-? SFCs counts; IFN-? SFCs counts in the HCMV pp65 antigenemia-positive and -negative groups were similar. More IFN-? SFCs counts were detected in transplant recipients with high anti-HCMV IgG antibody titers than in those with low anti-HCMV IgG titers pre-transplantation in the 47 recipients. Anti-HCMV IgG antibody titers were positively linearly correlated with IFN-? SFCs counts in HLA-A*02-positive recipients. The HCMV infection indicators used to monitor HCMV reactivation had different values in transplant recipients. The use of the IFN- ? SFCs counts measured by ELISPOT to evaluate the risk of HCMV reactivation needs further study. This article is protected by copyright. All rights reserved.
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3.
Risk Factors Analysis for Human Cytomegalovirus Viremia in Donor+/Recipient+ Hematopoietic Stem Cell Transplantation
Yang, R., Zhang, R., Zhang, Y., Huang, Y., Liang, H., Gui, G., Gong, S., Wang, H., Xu, M., Fan, J.
Laboratory medicine. 2020;51(1):74-79
Abstract
OBJECTIVE To assess the rate of, and risk factors for, human cytomegalovirus viremia (HCMV) in donor+/recipient+ (HCMV serostatus matched) hematopoietic stem-cell transplantation (HSCT) recipients. METHODS HCMV DNA from 144 donor+/recipient+ HSCT recipients was examined by quantitative polymerase chain reaction (qPCR). RESULTS The cumulative incidence of HCMV viremia was 69.4% (100/144) during the 48 weeks after HSCT. In a multivariate analysis, acute graft-versus-host disease (aGVHD) was discovered to be a risk factor for the occurrence of HCMV viremia (P = .006). The cumulative incidence of HCMV viremia and increasing DNA loads were significantly associated with aGVHD occurrence (P = .001 for each). The occurrence of late-term HCMV viremia was associated with aGVHD (P = .001) and a higher DNA load during the first 12 weeks after HSCT (P = .04). CONCLUSIONS aGVHD is a risk factor for HCMV viremia. Recipients with aGVHD who have a high HCMV DNA load should be strictly monitored to prevent HCMV activation.
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4.
Incidence, risk factors, and clinical significance of Epstein-Barr virus reactivation in myelodysplastic syndrome after allogeneic haematopoietic stem cell transplantation
Wang, H., Zhang, T. T., Qi, J. Q., Chu, T. T., Miao, M., Qiu, H. Y., Fu, C. C., Tang, X. W., Ruan, C. G., Wu, D. P., et al
Annals of hematology. 2019
Abstract
Epstein-Barr virus (EBV) reactivation is a life-threatening complication after allogeneic haematopoietic stem cell transplantation (allo-HSCT). In this study, we investigated the characteristics of EBV reactivation in 186 consecutive myelodysplastic (MDS) patients who underwent allo-HSCT in our centre. In 35 patients (18.8%) who experienced EBV reactivation after allo-HSCT, the median onset was 53 days (range 4-381 days). The cumulative incidence of EBV reactivation at the first, sixth, and twelfth month after allo-HSCT was 10.7%, 15.1%, and 17.9%, respectively. Twenty-five patients (71.4%) received pre-emptive rituximab therapy, and no patients developed post-transplant lymphoproliferative disorders. Stem cell source was proven to be a risk factor correlated with EBV reactivation. The cumulative incidence of relapse in the EBV-positive group was 11.4%, 25.2%, and 31.0% at the first, second, and third year after transplantation, respectively, being significantly higher than the corresponding 6.8%, 10.2%, and 10.2%, in the EBV-negative group (P = 0.014). Prognostic analysis showed that EBV reactivation was an independent risk factor for relapse-free survival (RFS). Patients in the EBV-positive group showed obviously shorter RFS than those in the EBV-negative group, with 3-year RFS of 62% and 85%, respectively (P = 0.017).
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5.
Positive stool culture could predict the clinical outcomes of haploidentical hematopoietic stem cell transplantation
Hu, L., Wang, Q., Zhang, X., Xu, L., Wang, Y., Yan, C., Chen, H., Chen, Y., Liu, K., Wang, H., et al
Frontiers of medicine. 2019
Abstract
We aimed to identify the effect of positive stool cultures (PSCs) on the clinical outcomes of patients undergoing haploidentical hematopoietic stem cell transplantation (haplo-HSCT) (n = 332). PSCs were observed in 61 patients (PSC group, 18.4%). Enterobacteriaceae in stool specimens was associated with a higher risk of bloodstream infection, and Candida in stool specimens was related to a higher risk of platelet engraftment failure. The cumulative incidence of infection-related mortality 1 year after haplo-HSCT in the PSC group was higher than that of the patients who showed persistently negative stool cultures (NSC group; 19.2% vs. 8.9%, P = 0.017). The probabilities of overall survival (71.4% vs. 83.8%, P = 0.031) and disease-free survival (69.6% vs. 81.0%, P = 0.048) 1 year after haplo-HSCT for the PSC group were significantly lower than those for the NSC group, particularly for patients who had Candida in their stool specimens. In multivariate analysis, Candida in stool specimens significantly increased the risk of mortality and was associated with poorer survival. Our results showed that PSC influenced the clinical outcomes after haplo-HSCT, particularly those who had Candida in their stool specimens.
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6.
Epidemiology and Outcomes of Hematopoietic Stem Cell Transplantation in Human Immunodeficiency Virus-Positive Patients From 1998 to 2012: A Nationwide Analysis
Mehta, K., Im, A., Rahman, F., Wang, H., Veldkamp, P.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2018;67(1):128-133
Abstract
BACKGROUND Prior studies have shown that outcomes of hematopoietic stem cell transplantation (HSCT) in human immunodeficiency virus (HIV)-positive patients have been similar to outcomes in HIV-negative patients since effective implementation of highly active antiretroviral therapy by 1998, but they are limited by small sample size or noninclusion of recent data. METHODS We queried National Inpatient Sample, a large inpatient data set in the United States, from 1998 to 2012 for HSCT, using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) procedure code 41.0. HIV-positive patients were identified by the presence of ICD-9-CM diagnostic codes 042, 043, 044, V08, and 079.53. The primary outcome was in-hospital mortality rate, and the secondary outcome the in-hospital complication rate of HSCT. Outcomes were assessed by means of univariate, multivariate regression and matched-pair analysis. RESULTS A total of 39517 patients who underwent HSCT were identified. Among these, 108 patients had HIV infection. There were no differences in in-hospital mortality rates or rates of intubation, sepsis, bacteremia, or graft-vs-host disease between HIV-positive and HIV-negative patients after allogeneic or autologous HSCT. In allogeneic HSCT, HIV-positive patients had a significantly higher incidence of nontuberculous mycobacterial and cytomegalovirus infection than HIV-negative patients. CONCLUSION Although HIV-positive patients may have a higher risk of certain opportunistic infections, they are not at higher risk of serious in-hospital complications of HSCT. Allogeneic and autologous HSCT can be safely performed in HIV-positive patients.
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7.
Early human herpes virus type 6 reactivation in umbilical cord blood allogeneic stem cell transplantation
Cirrone, F., Ippoliti, C., Wang, H., Zhou, X. K., Gergis, U., Mayer, S., Shore, T., van Besien, K.
Leukemia & Lymphoma. 2016;57(11):2555-9
Abstract
Human herpes virus type 6 can reactivate in patients after allogeneic stem cell transplantation and has been associated with serious sequelae such as delayed engraftment and an increased risk of developing acute graft-versus-host disease (GVHD). This study investigated human herpes virus type 6 (HHV-6) reactivation within 60 days of transplantation in stem cell transplants utilizing single umbilical cord blood, double umbilical cord blood, or umbilical cord blood plus haploidentical stem cells. Of 92 patients, 60 (65%) had HHV-6 reactivation. Reactivation was not significantly influenced by any patient characteristics, disease characteristics, or by stem cell source (umbilical cord blood only versus haploidentical plus umbilical cord blood). We did not observe any impact of HHV-6 reactivation on neutrophil or platelet count recovery or on relapse-free survival. HHV-6 reactivation was associated with subsequent development of prerelapse acute GVHD (HR=3.00; 95% CI, 1.4 to 6.4; p=0.004).
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8.
A comparison of lamivudine vs entecavir for prophylaxis of hepatitis B virus reactivation in allogeneic hematopoietic stem cell transplantation recipients: a single-institutional experience
Shang, J., Wang, H., Sun, J., Fan, Z., Huang, F., Zhang, Y., Jiang, Q., Dai, M., Xu, N., Lin, R., et al
Bone Marrow Transplantation. 2016;51(4):581-6
Abstract
The aim of this study was to compare the efficacy of lamivudine vs entecavir in the prevention of hepatitis B virus (HBV) reactivation in HBV surface Ag (HBsAg)-positive patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). A total of 216 consecutive patients were enrolled and retrospectively reviewed. Of these patients, 119 received lamivudine and 97 received entecavir. The median treatment duration to complete virological response in patients with baseline HBV-DNA levels >10(5) copies/mL was 2.0 months in the entecavir group, significantly shorter than that of the lamivudine group. After a median follow-up of 24 months post transplantation, the cumulative incidence rates of HBV reactivation at 6, 12 and 24 months following transplantation were 3.0%, 7.0% and 24.0% in the lamivudine group, and 0%, 0% and 2.0% in the entecavir group, respectively. In addition, entecavir treatment was associated with lower cumulative incidence rates of severe hepatitis caused by HBV reactivation. Mutations leading to drug resistance were detected in 25 patients in the lamivudine group and in only one patient in the entecavir group. Our data indicate that compared with lamivudine, entecavir has more potent antiviral efficacy and may be a better choice for prophylaxis of HBV reactivation in HBsAg-positive allo-HSCT recipients.