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Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients.

Publication ,  Journal Article
Heston, SM; Young, RR; Tanaka, JS; Jenkins, K; Vinesett, R; Saccoccio, FM; Martin, PL; Chao, NJ; Kelly, MS
Published in: Open Forum Infect Dis
February 2022

BACKGROUND: Cytomegalovirus (CMV) causes substantial morbidity and mortality after hematopoietic stem cell transplantation (HSCT). There are limited data on risk factors for CMV viremia and the safety of antiviral medications used to treat CMV in children. METHODS: We conducted a single-center retrospective study of children who underwent HSCT between 2000 and 2016. We used log-logistic regression to evaluate associations between clinical characteristics and CMV-free survival at 100 days after HSCT. We compared the incidences of laboratory-defined adverse events (AEs) during treatment with ganciclovir and foscarnet. RESULTS: Among 969 children, the median (interquartile range) age was 6.5 (3.1-11.5) years, and 80% underwent allogeneic HSCT. Two hundred forty-four (25%) children developed CMV viremia. Older age (odds ratio [OR], 0.95; 95% CI, 0.92-0.98), male sex (OR, 0.71; 95% CI, 0.51-0.99), non-Black, non-White race (OR, 0.56; 95% CI, 0.36-0.87), umbilical cord blood donor source (OR, 0.28; 95% CI, 0.08-0.97), and CMV seropositivity (R-/D+: OR, 0.17; 95% CI, 0.07-0.41; R+/D-: OR, 0.14; 95% CI, 0.09-0.21; R+/D+: OR, 0.08; 95% CI, 0.04-0.15) were associated with lower odds of 100-day CMV-free survival. Compared with foscarnet, ganciclovir was associated with lower incidences of thrombocytopenia (incidence rate ratio [IRR], 0.38; 95% CI, 0.15-0.97), electrolyte AEs (IRR, 0.42; 95% CI, 0.24-0.75), endocrine AEs (IRR, 0.52; 95% CI, 0.34-0.79), and renal AEs (IRR, 0.36; 95% CI, 0.19-0.65). CONCLUSIONS: CMV viremia occurred commonly among children after HSCT, and ganciclovir and foscarnet were associated with distinct toxicity profiles among children with CMV infection. These findings should be considered when developing CMV prevention and treatment strategies for children after HSCT.

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Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

February 2022

Volume

9

Issue

2

Start / End Page

ofab639

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Heston, S. M., Young, R. R., Tanaka, J. S., Jenkins, K., Vinesett, R., Saccoccio, F. M., … Kelly, M. S. (2022). Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients. Open Forum Infect Dis, 9(2), ofab639. https://doi.org/10.1093/ofid/ofab639
Heston, Sarah M., Rebecca R. Young, John S. Tanaka, Kirsten Jenkins, Richard Vinesett, Frances M. Saccoccio, Paul L. Martin, Nelson J. Chao, and Matthew S. Kelly. “Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients.Open Forum Infect Dis 9, no. 2 (February 2022): ofab639. https://doi.org/10.1093/ofid/ofab639.
Heston SM, Young RR, Tanaka JS, Jenkins K, Vinesett R, Saccoccio FM, et al. Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients. Open Forum Infect Dis. 2022 Feb;9(2):ofab639.
Heston, Sarah M., et al. “Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients.Open Forum Infect Dis, vol. 9, no. 2, Feb. 2022, p. ofab639. Pubmed, doi:10.1093/ofid/ofab639.
Heston SM, Young RR, Tanaka JS, Jenkins K, Vinesett R, Saccoccio FM, Martin PL, Chao NJ, Kelly MS. Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among Pediatric Hematopoietic Stem Cell Transplant Recipients. Open Forum Infect Dis. 2022 Feb;9(2):ofab639.
Journal cover image

Published In

Open Forum Infect Dis

DOI

ISSN

2328-8957

Publication Date

February 2022

Volume

9

Issue

2

Start / End Page

ofab639

Location

United States

Related Subject Headings

  • 3207 Medical microbiology
  • 3202 Clinical sciences