PMID- 26883100 OWN - NLM STAT- MEDLINE DCOM- 20171212 LR - 20221109 IS - 1949-2553 (Electronic) IS - 1949-2553 (Linking) VI - 7 IP - 13 DP - 2016 Mar 29 TI - Impact of cytomegalovirus reactivation on relapse and survival in patients with acute leukemia who received allogeneic hematopoietic stem cell transplantation in first remission. PG - 17230-41 LID - 10.18632/oncotarget.7347 [doi] AB - Cytomegalovirus (CMV)-reactivation is associated with graft-vs-leukemia (GVL) effect by stimulating natural-killer or T-cells, which showed leukemia relapse prevention after hematopoietic stem cell transplantation (HSCT). We enrolled patients with acute myeloid leukemia (n = 197) and acute lymphoid leukemia (n = 192) who underwent allogeneic-HSCT in first remission. We measured RQ-PCR weekly to detect CMV-reactivation and preemptively used ganciclovir (GCV) when the titer increased twice consecutively, but GCV was sometimes delayed in patients without significant graft-vs-host disease (GVHD) by reducing immunosuppressive agents. In the entire group, CMV-reactivation showed poor overall survival (OS). To evaluate subsequent effects of CMV-reactivation, we excluded early relapse and deaths within 100 days, during which most of the CMV-reactivation occurred. Untreated CMV-reactivated group (n = 173) showed superior OS (83.8% vs. 61.7% vs. 74.0%, p < 0.001) with lower relapse rate (10.1% vs 22.1% vs. 25.5%, p = 0.004) compared to GCV-treated CMV-reactivated group (n = 122) and CMV-undetected group (n = 42). After excluding chronic GVHD, untreated CMV-reactivated group still showed lower relapse rate (9.4% vs. 24.1% vs. 30.2%, p = 0.006). Multivariate analysis showed adverse-risk karyotype and patients in other than untreated CMV-reactivated group were independent factors for relapse prediction. Our data showed possible GVL effect of CMV-reactivation and minimizing antiviral therapy may benefit for relapse prevention in acute leukemia. FAU - Yoon, Jae-Ho AU - Yoon JH AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Lee, Seok AU - Lee S AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Kim, Hee-Je AU - Kim HJ AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Jeon, Young-Woo AU - Jeon YW AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Lee, Sung-Eun AU - Lee SE AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Cho, Byung-Sik AU - Cho BS AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Lee, Dong-Gun AU - Lee DG AD - Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Eom, Ki-Seong AU - Eom KS AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Kim, Yoo-Jin AU - Kim YJ AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Min, Chang-Ki AU - Min CK AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Cho, Seok-Goo AU - Cho SG AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Min, Woo-Sung AU - Min WS AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Lee, Jong Wook AU - Lee JW AD - Department of Hematology, Catholic Blood and Marrow Transplantation Center, Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. LA - eng PT - Journal Article PL - United States TA - Oncotarget JT - Oncotarget JID - 101532965 RN - 0 (Antiviral Agents) RN - P9G3CKZ4P5 (Ganciclovir) SB - IM MH - Acute Disease MH - Adolescent MH - Adult MH - Aged MH - Antiviral Agents/therapeutic use MH - Cytomegalovirus/physiology MH - Cytomegalovirus Infections/*complications/drug therapy/mortality MH - Female MH - Ganciclovir/therapeutic use MH - *Graft vs Leukemia Effect MH - *Hematopoietic Stem Cell Transplantation MH - Humans MH - Leukemia/mortality/therapy/*virology MH - Male MH - Middle Aged MH - Neoplasm Recurrence, Local/mortality/*virology MH - Transplantation, Homologous MH - Virus Activation MH - Young Adult PMC - PMC4941383 OTO - NOTNLM OT - acute lymphoid leukemia OT - acute myeloid leukemia OT - cytomegalovirus OT - graft-vs-leukemia COIS- CONFLICTS OF INTEREST The authors declare no competing financial interests in relation to this work. EDAT- 2016/02/18 06:00 MHDA- 2017/12/13 06:00 PMCR- 2016/03/29 CRDT- 2016/02/18 06:00 PHST- 2015/12/12 00:00 [received] PHST- 2016/01/29 00:00 [accepted] PHST- 2016/02/18 06:00 [entrez] PHST- 2016/02/18 06:00 [pubmed] PHST- 2017/12/13 06:00 [medline] PHST- 2016/03/29 00:00 [pmc-release] AID - 7347 [pii] AID - 10.18632/oncotarget.7347 [doi] PST - ppublish SO - Oncotarget. 2016 Mar 29;7(13):17230-41. doi: 10.18632/oncotarget.7347.