Scoring system for clinically significant CMV infection in seropositive recipients following allogenic hematopoietic cell transplant: an SFGM-TC study.

Date publication

décembre 2020

Journal

Bone marrow transplantation

Auteurs

Membres identifiés du Cancéropôle Est :
Pr DECONINCK Eric , Pr RUBIO Marie Thérèse

Tous les auteurs :
Beauvais D, Drumez E, Blaise D, Peffault de Latour R, Forcade E, Ceballos P, Uyttebroeck A, Labussière H, Nguyen S, Bourhis JH, Chevallier P, Thiebaut A, Poiré X, Maury S, Deconinck E, Cluzeau T, Brissot E, Huynh A, Rubio MT, Duhamel A, Yakoub-Agha I

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/33339900

Résumé

In order to identify cytomegalovirus (CMV)-seropositive patients who are at risk of developing CMV infection following first allogeneic hematopoietic cell transplantation (allo-HCT), we built up a scoring system based on patient/donor characteristics and transplantation modalities. To this end, 3690 consecutive patients were chronologically divided into a derivation cohort (2010-2012, n = 2180) and a validation cohort (2013-2014, n = 1490). Haploidentical donors were excluded. The incidence of first clinically significant CMV infection (CMV disease or CMV viremia leading to preemptive treatment) at 1, 3, and 6 months in the derivation cohort was 13.8%, 38.5%, and 39.6%, respectively. CMV-seropositive donor, unrelated donor (HLA matched 10/10 or HLA mismatched 9/10), myeloablative conditioning, total body irradiation, antithymocyte globulin, and mycophenolate mofetil significantly and independently affected the incidence of 3-month infection. These six factors were selected to build up the prognostic model. Four risk groups were defined: low, intermediate-low, intermediate-high, and high-risk categories, with a 3-month predicted incidence of first clinically significant CMV infection in the derivation cohort of 22.2%, 31.1%, 45.4%, and 56.9%, respectively. This score represents a framework for the evaluation of patients who are at risk of developing clinically significant CMV infection following allo-HCT. Prospective studies using this score may be of benefit in assessing the value of anti-CMV prophylaxis in well-defined patient cohorts.

Référence

Bone Marrow Transplant. 2020 Dec 18;: