Department of Hematology, Turku University Hospital, Hospital District of Southwest Finland, Turku, Finland.
Auria Clinical Informatics, Hospital District of Southwest Finland, Turku, Finland.
Transpl Infect Dis. 2022 Dec;24(6):e13947. doi: 10.1111/tid.13947. Epub 2022 Sep 27.
CMV infection is a common complication in allogeneic hematopoietic stem cell transplantation (HSCT). We investigated the association of clinically significant CMV (CS-CMV) infection with clinical outcomes and healthcare resource utilization in allogeneic HSCT patients in Finland.
This retrospective study included adult patients who received their first allogeneic HSCT between January 1, 2013, and December 31, 2018, at the Turku University Hospital. Data were collected from the hospital data lake. Clinical and healthcare outcomes were investigated at one year and mortality up to three years.
The study included 251 patients. CMV seroprevalence was 69.7%. CS-CMV infection occurred in 59.0% of the patients, and of those, 14.2% had ≥2 infections. The median time to CS-CMV infection was 34.5 days (Q -Q , 27.0-45.0). Recipient and donor seropositivity, and lymphoproliferative diseases were associated with higher, and HLA identical sibling donors with lower CS-CMV infection risk. CS-CMV infection was not associated with mortality in three years of follow-up. One hundred thirty-three (89.8%) and 75 (72.8%) patients with and without CS-CMV infection, respectively, were readmitted to the hospital. Patients with CS-CMV infection had more hospital readmissions (incidence rate ratio [IRR] 1.38, 95% confidence interval [CI] 1.10-1.73, p = .005) and patients with one CS-CMV infection (IRR 1.48, 95% CI 1.12-1.94, p = .005) or ≥2 infections had longer length of hospital stay (IRR 2.71, 95% CI 1.76-4.35, p < .001).
CMV seroprevalence is relatively high among Finnish allogeneic HSCT patients. CS-CMV infection was common and associated with a higher readmission rate and longer length of hospital stay.
巨细胞病毒（CMV）感染是异基因造血干细胞移植（HSCT）的常见并发症。我们研究了芬兰异基因 HSCT 患者中临床显著 CMV（CS-CMV）感染与临床结局和医疗资源利用之间的关系。
本回顾性研究纳入了 2013 年 1 月 1 日至 2018 年 12 月 31 日期间在图尔库大学医院接受首次异基因 HSCT 的成年患者。数据从医院数据湖中收集。在一年时调查临床和医疗结局，在三年内调查死亡率。
该研究纳入了 251 名患者。CMV 血清阳性率为 69.7%。59.0%的患者发生 CS-CMV 感染，其中 14.2%的患者发生≥2次感染。CS-CMV 感染的中位时间为 34.5 天（Q-Q，27.0-45.0）。受体和供体血清阳性和淋巴增生性疾病与更高的 CS-CMV 感染风险相关，而 HLA 完全匹配的同胞供体与更低的 CS-CMV 感染风险相关。在 3 年的随访中，CS-CMV 感染与死亡率无关。分别有 133（89.8%）和 75（72.8%）名有和无 CS-CMV 感染的患者再次入院。CS-CMV 感染患者的再次入院率更高（发病率比 [IRR] 1.38，95%置信区间 [CI] 1.10-1.73，p =.005），且发生 1 次 CS-CMV 感染（IRR 1.48，95%CI 1.12-1.94，p =.005）或≥2 次感染的患者住院时间更长（IRR 2.71，95%CI 1.76-4.35，p<.001）。
芬兰异基因 HSCT 患者的 CMV 血清阳性率相对较高。CS-CMV 感染很常见，与更高的再入院率和更长的住院时间有关。
