PMID- 32860467
OWN - NLM
STAT- MEDLINE
DCOM- 20210803
LR  - 20210803
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 23
IP  - 1
DP  - 2021 Feb
TI  - Reactivation of human herpesvirus 6 in pediatric allogeneic hematopoietic stem 
      cell transplant recipients.
PG  - e13453
LID - 10.1111/tid.13453 [doi]
AB  - BACKGROUND: Reactivation of human herpesvirus 6 (HHV-6) occurs in 30%-50% of 
      patients (pts) who receive allogeneic (allo) hematopoietic stem cell transplant 
      (HCT). However, the recommendation for post-transplant HHV-6 monitoring and 
      treatment in pediatric pts is not well established. METHODS: HHV-6 incidence 
      rates and the clinical outcomes were reported for 139 pediatric pts (</=18 years) 
      undergoing first allo-HCT at City of Hope from July 2011 to July 2017, for whom 
      HHV-6 was monitored weekly throughout HCT hospitalization. For 57 pediatric pts, 
      who underwent first HCT from January 2009 to July 2011, HHV-6 was tested as 
      clinically indicated and only rates of HHV-6 viremia were collected. RESULTS: 
      From July 2011 to July 2017, HHV-6 was detected in 88/139 pts (63%). The 
      frequency of HHV-6 viremia was associated with malignant diagnoses, myeloablative 
      conditioning, and cord blood HCT. Treatment with antiviral agents was offered to 
      symptomatic pts with a higher viral load (VL), for whom the time to VL clearance 
      was longer and the frequency of subsequent recurrences was higher. Pts with a 
      lower VL cleared HHV-6 without treatment. HHV-6 viremia was associated with a 
      higher frequency of grade II-IV acute graft-versus-host disease (GVHD) 
      (P = .022), but did not affect overall survival (OS), disease-free survival 
      (DFS), non-relapsed mortality (NRM), myeloid, or platelet (Plt) engraftment. 
      CONCLUSIONS: HHV-6 weekly screening is not necessary for all HCT pts but may be 
      considered for high-risk pts with malignant diagnoses undergoing cord blood HCT; 
      otherwise, HHV-6 should be tested as clinically indicated. Only symptomatic pts 
      (especially with a high VL > 25 000) could benefit from treatment. HHV-6 viremia 
      at the time of initiation and administration of the conditioning regimen cleared 
      promptly without the need to augment the transplant process.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Pawlowska, Anna B
AU  - Pawlowska AB
AUID- ORCID: 0000-0001-9466-6396
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
FAU - Karras, Nicole A
AU  - Karras NA
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
FAU - Liu, Huaying
AU  - Liu H
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
AD  - Department of Pediatrics, Nanfang Hospital, Southern Medical University, 
      Guangzhou, China.
FAU - DiMundo, Julie
AU  - DiMundo J
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
FAU - Cheng, Jerry C
AU  - Cheng JC
AD  - Kaiser Permanente, Los Angeles, CA, USA.
FAU - Sun, Weili
AU  - Sun W
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
AD  - Janssen Pharmaceuticals, Los Angeles, CA, USA.
FAU - Armenian, Saro
AU  - Armenian S
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
FAU - Yang, Dongyun
AU  - Yang D
AD  - Information Sciences, City of Hope, Duarte, CA, USA.
FAU - Palmer, Joycelynne M
AU  - Palmer JM
AD  - Information Sciences, City of Hope, Duarte, CA, USA.
FAU - Bell, Alison
AU  - Bell A
AD  - Information Sciences, City of Hope, Duarte, CA, USA.
FAU - Tahoun, Ahmed
AU  - Tahoun A
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
FAU - Tegtmeier, Bernard
AU  - Tegtmeier B
AD  - Division of Infectious Diseases, City of Hope, Duarte, CA, USA.
FAU - Dadwal, Sanjeet
AU  - Dadwal S
AD  - Division of Infectious Diseases, City of Hope, Duarte, CA, USA.
FAU - Rosenthal, Joseph
AU  - Rosenthal J
AD  - Department of Pediatrics, City of Hope, Duarte, CA, USA.
LA  - eng
PT  - Journal Article
DEP - 20200922
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
SB  - IM
MH  - Child
MH  - Cord Blood Stem Cell Transplantation
MH  - *Graft vs Host Disease
MH  - *Hematopoietic Stem Cell Transplantation
MH  - *Herpesvirus 6, Human
MH  - Humans
MH  - *Roseolovirus Infections
MH  - Transplantation Conditioning
OTO - NOTNLM
OT  - human herpesvirus 6
OT  - pediatric allogeneic hematopoietic stem cell transplant
EDAT- 2020/08/30 06:00
MHDA- 2021/08/04 06:00
CRDT- 2020/08/30 06:00
PHST- 2020/01/03 00:00 [received]
PHST- 2020/08/03 00:00 [revised]
PHST- 2020/08/08 00:00 [accepted]
PHST- 2020/08/30 06:00 [pubmed]
PHST- 2021/08/04 06:00 [medline]
PHST- 2020/08/30 06:00 [entrez]
AID - 10.1111/tid.13453 [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2021 Feb;23(1):e13453. doi: 10.1111/tid.13453. Epub 2020 Sep 
      22.