PMID- 35111869
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230214
IS  - 2328-8957 (Print)
IS  - 2328-8957 (Electronic)
IS  - 2328-8957 (Linking)
VI  - 9
IP  - 2
DP  - 2022 Feb
TI  - Risk Factors for CMV Viremia and Treatment-Associated Adverse Events Among 
      Pediatric Hematopoietic Stem Cell Transplant Recipients.
PG  - ofab639
LID - 10.1093/ofid/ofab639 [doi]
LID - ofab639
AB  - BACKGROUND: Cytomegalovirus (CMV) causes substantial morbidity and mortality 
      after hematopoietic stem cell transplantation (HSCT). There are limited data on 
      risk factors for CMV viremia and the safety of antiviral medications used to 
      treat CMV in children. METHODS: We conducted a single-center retrospective study 
      of children who underwent HSCT between 2000 and 2016. We used log-logistic 
      regression to evaluate associations between clinical characteristics and CMV-free 
      survival at 100 days after HSCT. We compared the incidences of laboratory-defined 
      adverse events (AEs) during treatment with ganciclovir and foscarnet. RESULTS: 
      Among 969 children, the median (interquartile range) age was 6.5 (3.1-11.5) 
      years, and 80% underwent allogeneic HSCT. Two hundred forty-four (25%) children 
      developed CMV viremia. Older age (odds ratio [OR], 0.95; 95% CI, 0.92-0.98), male 
      sex (OR, 0.71; 95% CI, 0.51-0.99), non-Black, non-White race (OR, 0.56; 95% CI, 
      0.36-0.87), umbilical cord blood donor source (OR, 0.28; 95% CI, 0.08-0.97), and 
      CMV seropositivity (R-/D+: OR, 0.17; 95% CI, 0.07-0.41; R+/D-: OR, 0.14; 95% CI, 
      0.09-0.21; R+/D+: OR, 0.08; 95% CI, 0.04-0.15) were associated with lower odds of 
      100-day CMV-free survival. Compared with foscarnet, ganciclovir was associated 
      with lower incidences of thrombocytopenia (incidence rate ratio [IRR], 0.38; 95% 
      CI, 0.15-0.97), electrolyte AEs (IRR, 0.42; 95% CI, 0.24-0.75), endocrine AEs 
      (IRR, 0.52; 95% CI, 0.34-0.79), and renal AEs (IRR, 0.36; 95% CI, 0.19-0.65). 
      CONCLUSIONS: CMV viremia occurred commonly among children after HSCT, and 
      ganciclovir and foscarnet were associated with distinct toxicity profiles among 
      children with CMV infection. These findings should be considered when developing 
      CMV prevention and treatment strategies for children after HSCT.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of 
      Infectious Diseases Society of America.
FAU - Heston, Sarah M
AU  - Heston SM
AUID- ORCID: 0000-0001-6150-1149
AD  - Division of Pediatric Infectious Diseases, Duke University Medical Center, 
      Durham, North Carolina, USA.
FAU - Young, Rebecca R
AU  - Young RR
AD  - Division of Pediatric Infectious Diseases, Duke University Medical Center, 
      Durham, North Carolina, USA.
AD  - Duke Clinical Research Institute, Durham, North Carolina, USA.
FAU - Tanaka, John S
AU  - Tanaka JS
AD  - Department of Medicine, Duke University Medical Center, Durham, North Carolina, 
      USA.
FAU - Jenkins, Kirsten
AU  - Jenkins K
AD  - Division of Pediatric Infectious Diseases, Duke University Medical Center, 
      Durham, North Carolina, USA.
FAU - Vinesett, Richard
AU  - Vinesett R
AD  - Division of Pediatric Transplant and Cellular Therapy, Duke University Medical 
      Center, Durham, North Carolina, USA.
FAU - Saccoccio, Frances M
AU  - Saccoccio FM
AD  - Division of Pediatric Infectious Diseases, University of Florida Shands 
      Children's Hospital, Gainesville, Florida, USA.
FAU - Martin, Paul L
AU  - Martin PL
AD  - Division of Pediatric Transplant and Cellular Therapy, Duke University Medical 
      Center, Durham, North Carolina, USA.
FAU - Chao, Nelson J
AU  - Chao NJ
AD  - Division of Hematologic Malignancies and Cellular Therapy, Duke University 
      Medical Center, Durham, North Carolina, USA.
FAU - Kelly, Matthew S
AU  - Kelly MS
AD  - Division of Pediatric Infectious Diseases, Duke University Medical Center, 
      Durham, North Carolina, USA.
LA  - eng
GR  - T32 HD094671/HD/NICHD NIH HHS/United States
PT  - Journal Article
DEP - 20211216
PL  - United States
TA  - Open Forum Infect Dis
JT  - Open forum infectious diseases
JID - 101637045
PMC - PMC8802801
OTO - NOTNLM
OT  - antivirals
OT  - cytomegalovirus viremia
OT  - foscarnet
OT  - ganciclovir
OT  - immunocompromised children
EDAT- 2022/02/04 06:00
MHDA- 2022/02/04 06:01
PMCR- 2021/12/16
CRDT- 2022/02/03 05:35
PHST- 2021/11/05 00:00 [received]
PHST- 2021/12/13 00:00 [accepted]
PHST- 2022/02/03 05:35 [entrez]
PHST- 2022/02/04 06:00 [pubmed]
PHST- 2022/02/04 06:01 [medline]
PHST- 2021/12/16 00:00 [pmc-release]
AID - ofab639 [pii]
AID - 10.1093/ofid/ofab639 [doi]
PST - epublish
SO  - Open Forum Infect Dis. 2021 Dec 16;9(2):ofab639. doi: 10.1093/ofid/ofab639. 
      eCollection 2022 Feb.