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Outcomes of hematopoietic cell transplantation using donors or recipients with inherited chromosomally integrated HHV-6

Blood, 2017-08, Vol.130 (8), p.1062-1069 [Peer Reviewed Journal]

2017 American Society of Hematology ;2017 by The American Society of Hematology. ;2017 by The American Society of Hematology 2017 ;ISSN: 0006-4971 ;EISSN: 1528-0020 ;DOI: 10.1182/blood-2017-03-775759 ;PMID: 28596425

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Title:
Outcomes of hematopoietic cell transplantation using donors or recipients with inherited chromosomally integrated HHV-6
Author: Hill, Joshua A. ; Magaret, Amalia S. ; Hall-Sedlak, Ruth ; Mikhaylova, Anna ; Huang, Meei-Li ; Sandmaier, Brenda M. ; Hansen, John A. ; Jerome, Keith R. ; Zerr, Danielle M. ; Boeckh, Michael
Subjects: Acute Disease ; Adult ; Chromosomes, Human - genetics ; Chromosomes, Human - virology ; Chronic Disease ; Female ; Graft vs Host Disease - genetics ; Hematopoietic Stem Cell Transplantation ; Herpesvirus 6, Human - genetics ; Humans ; Incidence ; Inheritance Patterns - genetics ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Probability ; Proportional Hazards Models ; Risk Factors ; Tissue Donors ; Transplantation ; Treatment Outcome
Is Part Of: Blood, 2017-08, Vol.130 (8), p.1062-1069
Description: Human herpesvirus 6 (HHV-6) species have a unique ability to integrate into chromosomal telomeres. Mendelian inheritance via gametocyte integration results in HHV-6 in every nucleated cell. The epidemiology and clinical effect of inherited chromosomally integrated HHV-6 (iciHHV-6) in hematopoietic cell transplant (HCT) recipients is unclear. We identified 4319 HCT donor–recipient pairs (8638 subjects) who received an allogeneic HCT and had archived pre-HCT peripheral blood mononuclear cell samples. We screened these samples for iciHHV-6 and compared characteristics of HCT recipients and donors with iciHHV-6 with those of recipients and donors without iciHHV-6, respectively. We calculated Kaplan-Meier probability estimates and Cox proportional hazards models for post-HCT outcomes based on recipient and donor iciHHV-6 status. We identified 60 HCT recipients (1.4%) and 40 donors (0.9%) with iciHHV-6; both recipient and donor harbored iciHHV-6 in 13 HCTs. Thus, there were 87 HCTs (2%) in which the recipient, donor, or both harbored iciHHV-6. Acute graft-versus-host disease (GVHD) grades 2-4 was more frequent when recipients or donors had iciHHV-6 (adjusted hazard ratios, 1.7-1.9; P = .004-.001). Cytomegalovirus viremia (any and high-level) was more frequent among recipients with iciHHV-6 (adjusted HRs, 1.7-3.1; P = .001-.040). Inherited ciHHV-6 status did not significantly affect risk for chronic GVHD, hematopoietic cell engraftment, overall mortality, or nonrelapse mortality. Screening for iciHHV-6 could guide donor selection and post-HCT risk stratification and treatment. Further study is needed to replicate these findings and identify potential mechanisms. •Inherited ciHHV-6 was detected in 1.4% of HCT recipients and 0.9% of their donors.•Acute GVHD grades 2-4 and cytomegalovirus viremia were more frequent when recipients or donors had inherited ciHHV-6.
Publisher: United States: Elsevier Inc
Language: English
Identifier: ISSN: 0006-4971
EISSN: 1528-0020
DOI: 10.1182/blood-2017-03-775759
PMID: 28596425
Source: GFMER Free Medical Journals
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Outcomes of hematopoietic cell transplantation using donors or recipients with inherited chromosomally integrated HHV-6

2017 American Society of Hematology ;2017 by The American Society of Hematology. ;2017 by The American Society of Hematology 2017 ;ISSN: 0006-4971 ;EISSN: 1528-0020 ;DOI: 10.1182/blood-2017-03-775759 ;PMID: 28596425

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