Risk Factors for Developing Human Herpesvirus 6 (HHV-6) Reactivation after Allogeneic Hematopoietic Stem Cell Transplantation and Its Association with Central Nervous System Disorders

Akiko Yamane, Takehiko Mori, Shigeaki Suzuki, Ai Mihara, Rie Yamazaki, Yoshinobu Aisa, Tomonori Nakazato, Takayuki Shimizu, Yasuo Ikeda, Shinichiro Okamoto

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Abstract

We prospectively evaluated the incidence of human herpesvirus 6 (HHV-6) DNAemia after allogeneic hematopoietic stem cell transplantation (HSCT) using quantitative plasma real-time polymerase chain reaction. Of 46 recipients of bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT) from related (n = 11) or unrelated donors (n = 22), and cord blood transplantation (CBT) from unrelated donors (n = 13), 22 (47.8%) developed HHV-6 DNAemia. HHV-6 DNA levels ranged from 200 to 200,000 copies/mL of plasma, and HHV-6 DNAemia was observed significantly more frequently after CBT than after BMT/PBSCT (92.3% vs 30.3%; P < .001). Multivariate analyses identified CBT (vs BMT/PBSCT), HLA mismatches between recipient and donor, and low anti-HHV-6 IgG titer before transplantation as the only risk factors for developing HHV-6 DNAemia. Three patients developed central nervous system (CNS) disorders with detectable HHV-6 DNA in the cerebrospinal fluid; all of these patients simultaneously developed HHV-6 DNAemia. These results suggest that HHV-6 DNAemia is frequently observed after allogeneic HSCT, especially in patients with the aforementioned risk factors. Thus, together with the assessment of risk factors, monitoring of HHV-6 DNAemia could be a useful asset in diagnosing HHV-6-associated CNS disorders.

Original languageEnglish
Pages (from-to)100-106
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume13
Issue number1
DOIs
Publication statusPublished - 2007 Jan

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Human Herpesvirus 6
Hematopoietic Stem Cell Transplantation
Central Nervous System Diseases
Transplantation
Fetal Blood
Unrelated Donors
Peripheral Blood Stem Cell Transplantation
DNA
Cerebrospinal Fluid
Real-Time Polymerase Chain Reaction
Multivariate Analysis
Immunoglobulin G
Bone Marrow

Keywords

  • Central nervous system disorders
  • Cord blood transplantation
  • Hematopoietic stem cell transplantation
  • Human herpesvirus 6
  • Polymerase chain reaction

ASJC Scopus subject areas

  • Transplantation

Cite this

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title = "Risk Factors for Developing Human Herpesvirus 6 (HHV-6) Reactivation after Allogeneic Hematopoietic Stem Cell Transplantation and Its Association with Central Nervous System Disorders",
abstract = "We prospectively evaluated the incidence of human herpesvirus 6 (HHV-6) DNAemia after allogeneic hematopoietic stem cell transplantation (HSCT) using quantitative plasma real-time polymerase chain reaction. Of 46 recipients of bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT) from related (n = 11) or unrelated donors (n = 22), and cord blood transplantation (CBT) from unrelated donors (n = 13), 22 (47.8{\%}) developed HHV-6 DNAemia. HHV-6 DNA levels ranged from 200 to 200,000 copies/mL of plasma, and HHV-6 DNAemia was observed significantly more frequently after CBT than after BMT/PBSCT (92.3{\%} vs 30.3{\%}; P < .001). Multivariate analyses identified CBT (vs BMT/PBSCT), HLA mismatches between recipient and donor, and low anti-HHV-6 IgG titer before transplantation as the only risk factors for developing HHV-6 DNAemia. Three patients developed central nervous system (CNS) disorders with detectable HHV-6 DNA in the cerebrospinal fluid; all of these patients simultaneously developed HHV-6 DNAemia. These results suggest that HHV-6 DNAemia is frequently observed after allogeneic HSCT, especially in patients with the aforementioned risk factors. Thus, together with the assessment of risk factors, monitoring of HHV-6 DNAemia could be a useful asset in diagnosing HHV-6-associated CNS disorders.",
keywords = "Central nervous system disorders, Cord blood transplantation, Hematopoietic stem cell transplantation, Human herpesvirus 6, Polymerase chain reaction",
author = "Akiko Yamane and Takehiko Mori and Shigeaki Suzuki and Ai Mihara and Rie Yamazaki and Yoshinobu Aisa and Tomonori Nakazato and Takayuki Shimizu and Yasuo Ikeda and Shinichiro Okamoto",
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T1 - Risk Factors for Developing Human Herpesvirus 6 (HHV-6) Reactivation after Allogeneic Hematopoietic Stem Cell Transplantation and Its Association with Central Nervous System Disorders

AU - Yamane, Akiko

AU - Mori, Takehiko

AU - Suzuki, Shigeaki

AU - Mihara, Ai

AU - Yamazaki, Rie

AU - Aisa, Yoshinobu

AU - Nakazato, Tomonori

AU - Shimizu, Takayuki

AU - Ikeda, Yasuo

AU - Okamoto, Shinichiro

PY - 2007/1

Y1 - 2007/1

N2 - We prospectively evaluated the incidence of human herpesvirus 6 (HHV-6) DNAemia after allogeneic hematopoietic stem cell transplantation (HSCT) using quantitative plasma real-time polymerase chain reaction. Of 46 recipients of bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT) from related (n = 11) or unrelated donors (n = 22), and cord blood transplantation (CBT) from unrelated donors (n = 13), 22 (47.8%) developed HHV-6 DNAemia. HHV-6 DNA levels ranged from 200 to 200,000 copies/mL of plasma, and HHV-6 DNAemia was observed significantly more frequently after CBT than after BMT/PBSCT (92.3% vs 30.3%; P < .001). Multivariate analyses identified CBT (vs BMT/PBSCT), HLA mismatches between recipient and donor, and low anti-HHV-6 IgG titer before transplantation as the only risk factors for developing HHV-6 DNAemia. Three patients developed central nervous system (CNS) disorders with detectable HHV-6 DNA in the cerebrospinal fluid; all of these patients simultaneously developed HHV-6 DNAemia. These results suggest that HHV-6 DNAemia is frequently observed after allogeneic HSCT, especially in patients with the aforementioned risk factors. Thus, together with the assessment of risk factors, monitoring of HHV-6 DNAemia could be a useful asset in diagnosing HHV-6-associated CNS disorders.

AB - We prospectively evaluated the incidence of human herpesvirus 6 (HHV-6) DNAemia after allogeneic hematopoietic stem cell transplantation (HSCT) using quantitative plasma real-time polymerase chain reaction. Of 46 recipients of bone marrow or peripheral blood stem cell transplantation (BMT/PBSCT) from related (n = 11) or unrelated donors (n = 22), and cord blood transplantation (CBT) from unrelated donors (n = 13), 22 (47.8%) developed HHV-6 DNAemia. HHV-6 DNA levels ranged from 200 to 200,000 copies/mL of plasma, and HHV-6 DNAemia was observed significantly more frequently after CBT than after BMT/PBSCT (92.3% vs 30.3%; P < .001). Multivariate analyses identified CBT (vs BMT/PBSCT), HLA mismatches between recipient and donor, and low anti-HHV-6 IgG titer before transplantation as the only risk factors for developing HHV-6 DNAemia. Three patients developed central nervous system (CNS) disorders with detectable HHV-6 DNA in the cerebrospinal fluid; all of these patients simultaneously developed HHV-6 DNAemia. These results suggest that HHV-6 DNAemia is frequently observed after allogeneic HSCT, especially in patients with the aforementioned risk factors. Thus, together with the assessment of risk factors, monitoring of HHV-6 DNAemia could be a useful asset in diagnosing HHV-6-associated CNS disorders.

KW - Central nervous system disorders

KW - Cord blood transplantation

KW - Hematopoietic stem cell transplantation

KW - Human herpesvirus 6

KW - Polymerase chain reaction

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