Faculty Collaboration Database

Virus detection in the cerebrospinal fluid of hematopoietic stem cell transplant recipients is associated with poor patient outcomes: a CIBMTR contemporary longitudinal study. Bone Marrow Transplant 2019 Aug;54(8):1354-1360

Date

01/31/2019

Pubmed ID

30696997

Pubmed Central ID

PMC7001099

DOI

10.1038/s41409-019-0457-9

Scopus ID

2-s2.0-85060913611 (requires institutional sign-in at Scopus site)   16 Citations

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.

Author List

Abidi MZ, Hari P, Chen M, Kim S, Battiwala M, Dahi PB, Diaz MA, Gale RP, Ganguly S, Gergis U, Green J, Hildebrandt G, Hill JA, Komanduri K, Lazarus H, Marks D, Nishihori T, Olsson R, Seo S, Ustun C, Yared J, Yin D, Wingard J, Wirk BM, Auletta J, Lindemans C, Riches M

Authors

Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin
Soyoung Kim PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

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