Absence of early HHV-6 reactivation after cord blood allograft predicts powerful graft-versus-tumor effect

Armin Rashidi, Maryam Ebadi, Bassil Said, Qing Cao, Ryan Shanley, Julie Curtsinger, Nelli Bejanyan, Erica D. Warlick, Jaime S. Green, Claudio G. Brunstein, Jeffrey S. Miller, Daniel J. Weisdorf

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Abstract

Approximately 75% of cord blood transplant (CBT) recipients experience human herpes virus-6 (HHV-6) reactivation. Considering the immunomodulatory effects of HHV-6, we hypothesized that early HHV-6 reactivation may influence the risk of relapse of the underlying hematologic malignancy. In 152 CBT recipients with hematological malignancies, we determined the association between HHV-6 reactivation by day +28 and 2-year cumulative incidence of relapse. In univariate analysis, the absence of HHV-6 reactivation (n = 32) was associated with less relapse (26 [18-35]% vs. 7 [0-17]% in groups with vs. without HHV-6 reactivation, respectively; P =.03). This difference was due to a remarkably low relapse incidence among patients without HHV-6 reactivation. In multivariable analysis, the absence of HHV-6 reactivation was associated with less relapse (hazard ratio [95% confidence interval]: 0.2 [0.05-0.9], P =.03). This association was independent of patient-, disease-, and transplant-related characteristics known to influence the risk of relapse. Natural killer cell and T-cell reconstitution at day +28 were similar between patients with vs. without HHV-6 reactivation. Our results suggest that CB allografts not complicated by HHV-6 reactivation by day +28 have a powerful graft-versus-tumor effect. Knowledge about early HHV-6 reactivation may stratify patients at day +28 into low vs. high relapse risk groups.

Original languageEnglish (US)
Pages (from-to)1014-1019
Number of pages6
JournalAmerican Journal of Hematology
Volume93
Issue number8
DOIs
StatePublished - Aug 1 2018

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Fetal Blood
Allografts
Viruses
Transplants
Neoplasms
Recurrence
Hematologic Neoplasms
Incidence
Natural Killer Cells
Confidence Intervals
T-Lymphocytes

PubMed: MeSH publication types

  • Journal Article

Cite this

Absence of early HHV-6 reactivation after cord blood allograft predicts powerful graft-versus-tumor effect. / Rashidi, Armin; Ebadi, Maryam; Said, Bassil; Cao, Qing; Shanley, Ryan; Curtsinger, Julie; Bejanyan, Nelli; Warlick, Erica D.; Green, Jaime S.; Brunstein, Claudio G.; Miller, Jeffrey S.; Weisdorf, Daniel J.

In: American Journal of Hematology, Vol. 93, No. 8, 01.08.2018, p. 1014-1019.

Research output: Contribution to journalArticle

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AU - Shanley, Ryan

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