TY - JOUR
T1 - QuantiFERON-cytomegalovirus to predict clinically significant cytomegalovirus infection after allogeneic hematopoietic stem cell transplantation
AU - Thompson, Grace
AU - Boan, Peter
AU - Purtill, Duncan
AU - Cooney, Julian
AU - Cannell, Paul
AU - Wright, Matthew
AU - John, Mina
N1 - Funding Information:
We thank Sue Buffery, bone marrow and stem cell transplant coordinator, for helping with patient recruitment. We acknowledge the work of PathWest Laboratory Medicine Western Australia staff at Fiona Stanley Hospital, for performing the QuantiFERON-cytomegalovirus assays. We thank all the patients who participated in the study.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/4
Y1 - 2022/4
N2 - Background: Controlling cytomegalovirus (CMV) infection through prophylaxis or pre-emptive therapy remains an important contributor to outcomes after allogeneic hematopoetic stem cell transplant (alloHCT). Predicting clinically significant CMV infection (csCMVi) after day 100 remains a challenge. Methods: We examined the abilty of the QuantiFERON-CMV assay (QFN-CMV) at day 100 (d100) and day 150 (d150) after alloHCT to predict csCMVi after these time points, with median follow-up of 3.1 years (range 1.3–4.3 years). Results: In 46 transplants (donor seropositive (D+) recipient seronegative (R-) = 12, D+R+ = 25, D-R+ = 9; matched related = 13, unrelated donor = 32, haploidentical = 1), for the prediction of freedom from csCMVi >d100, QFN-CMVd100 (positive compared to negative/indeterminate) had sensitivity 62% (23/37), specificity 100% (9/9), positive predictive value 100% (23/23), and negative predictive value 39% (9/23). For the prediction of freedom from csCMVi >d150, QFN-CMVd150 (positive compared to negative/indeterminate) had sensitivity 62% (18/29), specificity 83% (5/6), positive predictive value 95% (18/19), and negative predictive value 31% (5/16). Conclusion: Positive QFN-CMV at d100 and d150 strongly predicted freedom from csCMVi after these time points. QFN-CMV could be utilized to predict the need for pre-emptive therapy and CMV viral load monitoring after day 100 post-alloHCT.
AB - Background: Controlling cytomegalovirus (CMV) infection through prophylaxis or pre-emptive therapy remains an important contributor to outcomes after allogeneic hematopoetic stem cell transplant (alloHCT). Predicting clinically significant CMV infection (csCMVi) after day 100 remains a challenge. Methods: We examined the abilty of the QuantiFERON-CMV assay (QFN-CMV) at day 100 (d100) and day 150 (d150) after alloHCT to predict csCMVi after these time points, with median follow-up of 3.1 years (range 1.3–4.3 years). Results: In 46 transplants (donor seropositive (D+) recipient seronegative (R-) = 12, D+R+ = 25, D-R+ = 9; matched related = 13, unrelated donor = 32, haploidentical = 1), for the prediction of freedom from csCMVi >d100, QFN-CMVd100 (positive compared to negative/indeterminate) had sensitivity 62% (23/37), specificity 100% (9/9), positive predictive value 100% (23/23), and negative predictive value 39% (9/23). For the prediction of freedom from csCMVi >d150, QFN-CMVd150 (positive compared to negative/indeterminate) had sensitivity 62% (18/29), specificity 83% (5/6), positive predictive value 95% (18/19), and negative predictive value 31% (5/16). Conclusion: Positive QFN-CMV at d100 and d150 strongly predicted freedom from csCMVi after these time points. QFN-CMV could be utilized to predict the need for pre-emptive therapy and CMV viral load monitoring after day 100 post-alloHCT.
KW - bone marrow transplant
KW - cytomegalovirus
KW - interferon gamma release assay
KW - QuantiFERON
KW - stem cell transplant
KW - T-cell immunity
UR - http://www.scopus.com/inward/record.url?scp=85123590043&partnerID=8YFLogxK
U2 - 10.1111/tid.13786
DO - 10.1111/tid.13786
M3 - Article
C2 - 34994053
AN - SCOPUS:85123590043
SN - 1398-2273
VL - 24
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
IS - 2
M1 - e13786
ER -