{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T10:51:04Z","timestamp":1775904664815,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Cytomegalovirus (CMV) infections remain a major complication following allogeneic hematopoietic stem cell transplantation (allo\u2010HCT), with refractory infections associated with increased morbidity and mortality. Machine learning (ML) approaches may improve risk stratification and clinical management of CMV infections. This retrospective multicenter study analyzed 933 allo\u2010HCT recipients from 21 Spanish centers (2014\u20132018) using data from the Spanish Hematopoietic Transplantation and Cell Therapy Group registry. Three ML models were developed to predict: (1) CMV DNAemia occurrence, (2) clinically significant CMV infection (csCMV\u2010I), and (3) refractory CMV infection (CMV\u2010R). Six supervised ML algorithms were evaluated using 25 repeated fivefold stratified cross\u2010validation, including Random Forest, Support Vector Machine, Decision Trees, XGBoost, Elastic Net, and PLS\u2010Logistic Regression. CMV DNAemia occurred in 493 recipients (53%), with 356 (72%) developing CsCMV\u2010I and 91 (26%) progressing to CMV\u2010R. The optimal models achieved: XGBoost for CMV DNAemia and CsCMV\u2010I prediction (sensitivity 0.97) and SVM for CMV\u2010R prediction (sensitivity 0.58). Key predictive features included recipient CMV serostatus, conditioning regimens, GvHD occurrence, recipient characteristics, and immunosuppressive protocols, with distinct signatures for each outcome. ML models successfully identified distinct clinical profiles associated with different CMV outcomes in allo\u2010HCT recipients, achieving high sensitivity but moderate discriminatory capacity (AUC 0.55\u20130.67). Despite limitations including pre\u2010letermovir era data, this work establishes a foundation for precision risk stratification as a complement to\u2014not replacement for\u2014current prophylaxis strategies. Prospective validation in contemporary cohorts is needed before clinical implementation.<\/jats:p>","DOI":"10.1002\/jmv.70867","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T09:46:12Z","timestamp":1773395172000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unveiling CMV Risk Signatures After Allogeneic Stem Cell Transplantation Through Machine Learning Approaches: A Multicenter Analysis From the GETH\u2010TC"],"prefix":"10.1002","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1774-9790","authenticated-orcid":false,"given":"Estela","family":"Gim\u00e9nez","sequence":"first","affiliation":[{"name":"Microbiology Service, Hospital Cl\u00ednico Universitario, Biomedical Research Institute INCLIVA Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Rodriguez\u2010Belenguer","sequence":"additional","affiliation":[{"name":"Biomedical Imaging Research Group (GIBI230), Instituto de Investigaci\u00f3n Sanitaria La Fe (IIS La Fe) Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Solano","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Cl\u00ednico Universitario, Biomedical Research Institute INCLIVA Valencia Spain"},{"name":"Department of Medicine, School of Medicine University of Valencia Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lourdes","family":"V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Hematology Department Complejo Asistencial Universitario de Salamanca\u2010IBSAL Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Martino","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Sant Creu i Sant Pau Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael de la","family":"C\u00e1mara","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital de la Princesa Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Rovira","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Clinic Institute of Hematology &amp; Oncology Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ildefonso","family":"Espigado","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Virgen del Roc\u00edo Sevilla Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen M.","family":"Calvo","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Universitario Reina Sof\u00eda, C\u00f3rdoba  Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"L\u00f3pez\u2010Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Ram\u00f3n y Cajal Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariadna","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Cl\u00ednico Universitario, Biomedical Research Institute INCLIVA Valencia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ar\u00e1nzazu","family":"Berm\u00fadez","sequence":"additional","affiliation":[{"name":"Department of Hematology Hospital Marques de Valdecilla Santander Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Salda\u00f1a","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital Universitario de Jerez, Jerez de la Frontera C\u00e1diz Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inmaculada","family":"Heras","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario Morales Meseguer y Centro Regional de Hemodonaci\u00f3n, IMIB Universidad de Murcia Murcia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana J.","family":"Gonz\u00e1lez\u2010Huerta","sequence":"additional","affiliation":[{"name":"Hematology\u2010Stem Cell Transplantation Unit, Hospital Universitario Central de Asturias, Oviedo IISPA. 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Informe de Posicionamiento Terap\u00e9utico de Prevymis\u00ae (letermovir) [en l\u00ednea]. Madrid: AEMPS 2019 [consulta: 12 octubre 2025]. 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