Introduction: HSV is a signifi cant infectious pathogen in alloHSCT recipients. Organ and tissue damage, duration and intensity of immunosupression are among main triggering factors of HSV reactivation. We supposed that allo-HSCT with reducedintensity conditioning (RIC) would decrease HSV reactivation due to reduced organ and tissue damage. Objectives: studying incidence of HSV reactivation in allo-HSCT with myeloablative conditioning (MAC) vs RIC, and studies of correlations between HSV reactivation and incidence/severity complications in allo-HSCT. Patient and methods. Fifty-four children and adolescents up to 21 years old with ALL and AML underwent matched related and unrelated HSCT (either bone marrow or peripheral stem cells) with MAC (n=31) and RIC (n=23) were included in the study. HSV reactivation (HSV+) was detected by means of qualitative PCR in blood, performed weekly both before and after engraftment until d+30. Toxic complications (hepatitis, neurological disorders etc) were determined according to appropriate criteria. Results: We compared the incidence some toxic complications (mucositis, severe mucositis, hepatitis, neurological disorders), occurrence of acute graft-versus-host-disease (aGVHD), including aGVHD III-IV, intestinal aGVHD, hepatic aGVHD, incidence of infectious complications, including aspergillosis and sepsis in the following groups: "œallo-HSCT HSV+" vs "œalloHSCT HSV-", "œMAC HSCT HSV+ vs MAC HSCT HSV-", "œRIC HSCT HSV+ vs RIC HSCT HSV-", "œMAC HSCT HSV+ vs RIC HSV+", "œMAC HSCT HSV- vs RIC HSCT HSV-". Observed difference in evaluated groups haven’t any statistical signifi cance, only a strong tend to more frequent rate of infectious complications in "œallo-HSCT HSV+" group vs "œallo-HSCT HSV-"œ group were observed, 88% and 39% respectively (p=0,057). Conclusion: HSV reactivation may have some relations with transplant-related morbidity, especially with other infections.
Full conference title:
Annual Meeting of the EBMT, 37th
- EBMT 37th (2011)