Characteristics of study subjects
| Characteristic . | All patients . | EC (n = 13) . | SCs (n = 16) . | NCs (n = 13) . | P* . | P† . |
|---|---|---|---|---|---|---|
| Age, median (IQR), y | 57 (48-63) | 57 (46-61) | 57 (51-62) | 58 (46-65) | .86 | .91 |
| Male sex | 26 (62) | 7 (54) | 10 (63) | 9 (69) | .79 | >.99 |
| Follow-up, median (IQR), post-HCT days | 511 (227-778) | 373 (210-922) | 602 (453-822) | 529 (76-772) | .48 | .37 |
| Time to CMV reactivation, median (IQR), posttransplant days | 30 (12-35) | NA | 34 (15-57) | 18 (5-33) | n/a | .03 |
| CMV reactivation within 30 d posttransplant | 12 (29) | NA | 6 (38) | 6 (46) | n/a | .72 |
| Initial CMV DNAemia, median (IQR), IU/mL | 106 (96-137) | NA | 102 (96-137) | 106 (96-181) | n/a | .62 |
| Peak CMV DNAemia, median (IQR), IU/mL | 377 (137-1800) | NA | 140 (137-192) | 1,832 (1600-9189) | n/a | <.0001 |
| CMV DNAemia preceding therapy, median (IQR), IU/mL | 873 (700-1500) | NA | n/a | 873 (700-1500) | n/a | n/a |
| Duration of CMV DNAemia, median (IQR), d | 30 (22-40) | NA | 22 (5-32) | 40 (30-60) | n/a | .0008 |
| CMV DNAemia lasting >7 d | 24 (57) | NA | 11 (69) | 13 (100) | n/a | .048 |
| Recurrent CMV DNAemia (ie, ≥2 episodes of viremia)‡ | 10 (26) | NA | 4 (25) | 6 (60) | n/a | .11 |
| CMV disease | 4 (9.5) | 0 | 1 (6.3) | 3 (23) | .18 | .29 |
| Underlying diagnosis | ||||||
| Leukemia | 24 (57) | 10 (77) | 8 (50) | 6 (46) | .25 | >.99 |
| Lymphoma | 6 (14) | 1 (8) | 1 (6) | 4 (31) | .22 | .14 |
| MDS/MPN | 12 (29) | 2 (15) | 7 (44) | 3 (23) | .25 | .43 |
| Conditioning regimen | ||||||
| Myeloablative§ | 11 (26) | 3 (23) | 2 (13) | 6 (46) | .2 | .1 |
| Stem cell source | ||||||
| Peripheral blood | 41 (98) | 13 (100) | 16 (100) | 12 (92) | .62 | .44 |
| Bone marrow | 1 (2) | 0 | 0 | 1 (8) | ||
| Type of donor | ||||||
| Unrelated‖ | 20 (48) | 4 (31) | 5 (31) | 11 (85) | .006 | .008 |
| HLA-matched related | 22 (52) | 9 (69) | 11 (69) | 2 (15) | ||
| Malignancy status at time of transplant | ||||||
| Complete remission | 26 (62) | 9 (69) | 9 (56) | 8 (62) | .92 | >.99 |
| Time to engraftment, median (IQR), d | 10 (11-13) | 11 (9-18) | 11 (10-13) | 12 (11-19) | .49 | .28 |
| aGVHD (grade 2-4)¶ | 13 (31) | 3 (23) | 5 (31) | 5 (38) | .65 | .71 |
| Steroids (>0.5mg/kg), day 30 | 6 (14) | 2 (15) | 1 (6) | 3 (23) | .47 | .29 |
| (D)onor/(R)ecipient CMV serostatus | ||||||
| D− R+ | 12 (29) | 3 (23) | 6 (38) | 3 (23) | .63 | .45 |
| D+ R+ | 30 (71) | 10 (77) | 10 (62) | 10 (77) | ||
| CD34+ cells infused (1 × 106), median (IQR) | 7.4 (5.8-9.4) | 7.8 (6.7-12) | 7.6 (6.5-10) | 6.0 (3.5-7.3) | .04 | .045 |
| Charlson Comorbidity Score, median (IQR) | 3 (2-5) | 3 (2-4) | 3 (2-5) | 3 (2-7) | .68 | .49 |
| Lymphoid malignancy | 11 (26) | 5 (38) | 1 (6) | 5 (38) | .06 | .06 |
| Absolute lymphocyte count, day 30, cells/µL | 800 (480-1380) | 800 (350-1390) | 950 (725-1623) | 700 (250-1300) | .35 | .17 |
| Time to “day 30” sample collection, median (range), d | 29 (27-31) | 28 (25-31) | 30 (28-32) | 29 (27-31) | .11 | .15 |
| 1-y bacterial or fungal invasive infections | 8 (19) | 2 (15) | 1 (6) | 5 (38) | .13 | .06 |
| 100-d all-cause mortality | 5 (12) | 1 (8) | 0 | 4 (31) | .03 | .03 |
| 1-y all-cause mortality | 9 (21) | 2 (15) | 2 (13) | 5 (38) | .25 | .19 |
| 3-y all-cause mortality | 10 (24) | 2 (15) | 3 (19) | 5 (38) | .39 | .41 |
| 100-d NRM | 3 (7) | 1 (8) | 0 | 2 (15) | .28 | .19 |
| 1-y NRM | 5 (12) | 1 (8) | 1 (6) | 3 (23) | .49 | .29 |
| 3-y NRM | 5 (12) | 1 (8) | 1 (6) | 3 (23) | .49 | .29 |
| Characteristic . | All patients . | EC (n = 13) . | SCs (n = 16) . | NCs (n = 13) . | P* . | P† . |
|---|---|---|---|---|---|---|
| Age, median (IQR), y | 57 (48-63) | 57 (46-61) | 57 (51-62) | 58 (46-65) | .86 | .91 |
| Male sex | 26 (62) | 7 (54) | 10 (63) | 9 (69) | .79 | >.99 |
| Follow-up, median (IQR), post-HCT days | 511 (227-778) | 373 (210-922) | 602 (453-822) | 529 (76-772) | .48 | .37 |
| Time to CMV reactivation, median (IQR), posttransplant days | 30 (12-35) | NA | 34 (15-57) | 18 (5-33) | n/a | .03 |
| CMV reactivation within 30 d posttransplant | 12 (29) | NA | 6 (38) | 6 (46) | n/a | .72 |
| Initial CMV DNAemia, median (IQR), IU/mL | 106 (96-137) | NA | 102 (96-137) | 106 (96-181) | n/a | .62 |
| Peak CMV DNAemia, median (IQR), IU/mL | 377 (137-1800) | NA | 140 (137-192) | 1,832 (1600-9189) | n/a | <.0001 |
| CMV DNAemia preceding therapy, median (IQR), IU/mL | 873 (700-1500) | NA | n/a | 873 (700-1500) | n/a | n/a |
| Duration of CMV DNAemia, median (IQR), d | 30 (22-40) | NA | 22 (5-32) | 40 (30-60) | n/a | .0008 |
| CMV DNAemia lasting >7 d | 24 (57) | NA | 11 (69) | 13 (100) | n/a | .048 |
| Recurrent CMV DNAemia (ie, ≥2 episodes of viremia)‡ | 10 (26) | NA | 4 (25) | 6 (60) | n/a | .11 |
| CMV disease | 4 (9.5) | 0 | 1 (6.3) | 3 (23) | .18 | .29 |
| Underlying diagnosis | ||||||
| Leukemia | 24 (57) | 10 (77) | 8 (50) | 6 (46) | .25 | >.99 |
| Lymphoma | 6 (14) | 1 (8) | 1 (6) | 4 (31) | .22 | .14 |
| MDS/MPN | 12 (29) | 2 (15) | 7 (44) | 3 (23) | .25 | .43 |
| Conditioning regimen | ||||||
| Myeloablative§ | 11 (26) | 3 (23) | 2 (13) | 6 (46) | .2 | .1 |
| Stem cell source | ||||||
| Peripheral blood | 41 (98) | 13 (100) | 16 (100) | 12 (92) | .62 | .44 |
| Bone marrow | 1 (2) | 0 | 0 | 1 (8) | ||
| Type of donor | ||||||
| Unrelated‖ | 20 (48) | 4 (31) | 5 (31) | 11 (85) | .006 | .008 |
| HLA-matched related | 22 (52) | 9 (69) | 11 (69) | 2 (15) | ||
| Malignancy status at time of transplant | ||||||
| Complete remission | 26 (62) | 9 (69) | 9 (56) | 8 (62) | .92 | >.99 |
| Time to engraftment, median (IQR), d | 10 (11-13) | 11 (9-18) | 11 (10-13) | 12 (11-19) | .49 | .28 |
| aGVHD (grade 2-4)¶ | 13 (31) | 3 (23) | 5 (31) | 5 (38) | .65 | .71 |
| Steroids (>0.5mg/kg), day 30 | 6 (14) | 2 (15) | 1 (6) | 3 (23) | .47 | .29 |
| (D)onor/(R)ecipient CMV serostatus | ||||||
| D− R+ | 12 (29) | 3 (23) | 6 (38) | 3 (23) | .63 | .45 |
| D+ R+ | 30 (71) | 10 (77) | 10 (62) | 10 (77) | ||
| CD34+ cells infused (1 × 106), median (IQR) | 7.4 (5.8-9.4) | 7.8 (6.7-12) | 7.6 (6.5-10) | 6.0 (3.5-7.3) | .04 | .045 |
| Charlson Comorbidity Score, median (IQR) | 3 (2-5) | 3 (2-4) | 3 (2-5) | 3 (2-7) | .68 | .49 |
| Lymphoid malignancy | 11 (26) | 5 (38) | 1 (6) | 5 (38) | .06 | .06 |
| Absolute lymphocyte count, day 30, cells/µL | 800 (480-1380) | 800 (350-1390) | 950 (725-1623) | 700 (250-1300) | .35 | .17 |
| Time to “day 30” sample collection, median (range), d | 29 (27-31) | 28 (25-31) | 30 (28-32) | 29 (27-31) | .11 | .15 |
| 1-y bacterial or fungal invasive infections | 8 (19) | 2 (15) | 1 (6) | 5 (38) | .13 | .06 |
| 100-d all-cause mortality | 5 (12) | 1 (8) | 0 | 4 (31) | .03 | .03 |
| 1-y all-cause mortality | 9 (21) | 2 (15) | 2 (13) | 5 (38) | .25 | .19 |
| 3-y all-cause mortality | 10 (24) | 2 (15) | 3 (19) | 5 (38) | .39 | .41 |
| 100-d NRM | 3 (7) | 1 (8) | 0 | 2 (15) | .28 | .19 |
| 1-y NRM | 5 (12) | 1 (8) | 1 (6) | 3 (23) | .49 | .29 |
| 3-y NRM | 5 (12) | 1 (8) | 1 (6) | 3 (23) | .49 | .29 |
Data are presented as absolute number (percentage), unless specified otherwise. Statistically significant P values (P < .05) are indicated in bold.
aGVHD, acute graft-versus-host disease; ATG, antithymocyte globulin; IQR, interquartile range; MDS/MPN, myelodysplastic syndrome/ myeloproliferative neoplasm.
P value for comparison between the 3 groups by using Kruskal-Wallis or Fisher’s exact test.
P value for comparison between SCs and NCs groups by using Mann-Whitney U or Fisher’s exact test.
Excluding 3 patients from the NCs group who never achieved viral clearance.
Other patients received reduced intensity conditioning. Missing data on 1 patient from SCs group.
Includes 4 mismatched unrelated donors and 16 matched unrelated donors. All unrelated donor recipients at our center undergo T-cell depletion with ATG during conditioning regimen. Typical dose of ATG at our center is 4 mg/kg total.
Median time from transplant to aGVHD was 108 d (IQR, 43-123).