Effect of Cytomegalovirus Reactivation on Relapse after Allogeneic Hematopoietic Stem Cell Transplantation in XXXX .

@entity1 @entity981 @entity5 @entity3052 @entity2132 @entity2834 @entity1292
UNASSIGNED: Recent studies have demonstrated the protective effect of cytomegalovirus ( @entity2834 ) reactivation against relapse after allogeneic hematopoietic stem cell transplantation (HSCT) for adult @entity5 . We assessed the association of @entity2834 reactivation, defined as the development of CMV antigenemia (at least 1 pp65 antigen-positive cell per 5.0  *  10(4) WBCs) within 100  days after HSCT, with the risk of relapse in 143 @entity1 with pediatric @entity3052 . The median age at HSCT was 7  years, and underlying diseases included @entity981 in 101 @entity1 and @entity3052 in 42. The cumulative incidence of @entity2834 reactivation at day 100 after HSCT was 45.4%. At a median follow-up of 88  months, @entity1 with @entity2834 reactivation had significantly lower 5-year cumulative incidence of relapse compared with @entity1 without @entity2834 reactivation. In a multivariate analysis, high-level @entity2834 reactivation (>= 10 pp65 antigen-positive cells) was an independent factor associated with reduced relapse. However, @entity2834 reactivation was also associated with higher nonrelapse mortality (NRM), mostly caused by @entity1292 after grades II to IV @entity2132 ( @entity2132 ), which resulted in decreased probability of survival. High-level @entity2834 reactivation was a risk factor for increased NRM and worse overall survival in multivariate analysis. Although @entity2834 reactivation may reduce the risk of relapse after HSCT for pediatric @entity3052 , effective management of severe acute @entity2132 and better prophylaxis and treatment of @entity1292 are required to reduce the incidence of NRM and improve survival. Further studies on pediatric HSCT that include a larger number of @entity1 and more homogenous @entity1 cohorts are desirable.
