Title

Virus detection in the cerebrospinal fluid of hematopoietic stem cell transplant recipients is associated with poor patient outcomes: a CIBMTR contemporary longitudinal study.

Document Type

Article

Publication Date

8-2019

Identifier

DOI: 10.1038/s41409-019-0457-9; PMCID: PMC7001099

Abstract

Limited data exist on characteristics of central nervous system viruses (CNS-V) in allogeneic hematopoietic stem cell transplant (HCT) recipients. Between 2007 and 2015, the Center for International Blood and Marrow Transplant Research (CIBMTR) received information on 27,532 patients undergoing HCT. Of these, centers reported 165 HCT recipients with CNS-V detected in cerebrospinal fluid within 6 months after HCT. CNS viruses predominantly included human herpes virus 6 (HHV-6) (73%), followed by Epstein-Barr Virus (10%), cytomegalovirus (3%), varicella zoster virus (3%), herpes simplex virus (3%) and Adenovirus (3%). Median time of viral detection in CNS was 31 days after HCT; and viral detection was earlier in patients with CNS HHV-6. Concurrent viremia occurred in 52% of patients. Cord blood transplant recipients (CBT) accounted for the majority (53%) of patients with CNS-V. Myeloablative conditioning (65%), use of fludarabine (63%), or use of anti-thymocyte globulin (61%) were also predominant. Overall survival from the time of detection of CNS-V was 50% at 6 months and 30% at 5 years. Infections were the leading cause of death (32%). In summary, CBT recipients predominated in the population with CNS-V. Outcomes after CNS-V were poor with significant mortality seen in the first 6 months.

Journal Title

Bone marrow transplantation

Volume

54

Issue

8

First Page

1354

Last Page

1360

MeSH Keywords

Adolescent; Adult; Aged; Child; Child, Preschool; DNA, Viral; Female; Hematopoietic Stem Cell Transplantation; Humans; Longitudinal Studies; Male; Middle Aged; Transplantation Conditioning; Virus Diseases; Young Adult

Keywords

Viral DNA; Hematopoietic Stem Cell Transplantation; Humans; Longitudinal Studies; Transplantation Conditioning; Virus Diseases

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