{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:41:12Z","timestamp":1770828072655,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003463","name":"Haematology Society of Australia and New Zealand","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003463","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000926","name":"Leukaemia Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000926","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cytomegalovirus (CMV) reactivation is a frequent complication after allogeneic hematopoietic cell transplant (alloHCT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We analyzed 159 alloHCT recipients with 4409 quantitative CMV viral loads to determine pre\u2010transplant predictors of CMV reactivation, clinically significant CMV infection (cs\u2010CMVi, defined as CMV viral load &gt;1000\u00a0IU\/mL), CMV disease, kinetics of spontaneous clearance of CMV, and survival using a standardized pre\u2010emptive therapy approach to identify at\u2010risk groups to target prevention strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cs\u2010CMVi was most common in D\u2212\/R+ unrelated donor transplants (URD). Spontaneous CMV clearance occurred in 26% of patients who reached a viral load of 56\u2010137\u00a0IU\/mL, 6% at 138\u2010250\u00a0IU\/mL and in one patient &gt;250\u00a0IU\/mL. Median time between the first CMV reactivation (&gt;56\u00a0IU\/mL) and a viral load &gt;250\u00a0IU\/mL was 13\u00a0days, whereas the time from the first viral load &gt;250\u00a0IU\/mL to reach a vial load &gt;1000\u00a0IU\/mL was 4\u00a0days. Cs\u2010CMVi was associated with a significant increase in non\u2010relapse mortality (NRM) on multivariate analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, this study indicates that D\u2212\/R+ URD recipients are at high\u2010risk for cs\u2010CMVi\u2010 and CMV\u2010related mortality, and are potential candidates for targeted CMV prophylaxis. Spontaneous clearance of CMV beyond a viral load of 250\u00a0IU\/mL is uncommon, suggesting that this could be used as an appropriate threshold to initiate pre\u2010emptive therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13548","type":"journal-article","created":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T17:18:50Z","timestamp":1608484730000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cytomegalovirus (CMV) management in allogeneic hematopoietic cell transplantation: Pre\u2010transplant predictors of survival, reactivation, and spontaneous clearance"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7086-538X","authenticated-orcid":false,"given":"Julian","family":"Lindsay","sequence":"first","affiliation":[{"name":"Haematology Department Royal North Shore Hospital Sydney Australia"},{"name":"National Centre for Infection in Cancer Peter MacCallum Cancer Centre Melbourne Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jad","family":"Othman","sequence":"additional","affiliation":[{"name":"Haematology Department Royal North Shore Hospital Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Kerridge","sequence":"additional","affiliation":[{"name":"Haematology Department Royal North Shore Hospital Sydney Australia"},{"name":"Northern Blood Research Centre Kolling Institute of Medical Research University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Fay","sequence":"additional","affiliation":[{"name":"Haematology Department Royal North Shore Hospital Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Haematology Department Royal North Shore Hospital Sydney Australia"},{"name":"Northern Blood Research Centre Kolling Institute of Medical Research University of Sydney Sydney NSW Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Arthur","sequence":"additional","affiliation":[{"name":"Haematology Department Royal North Shore Hospital Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon C.\u2010A.","family":"Chen","sequence":"additional","affiliation":[{"name":"National Centre for Infection in Cancer Peter MacCallum Cancer Centre Melbourne Australia"},{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services Institute of Clinical Pathology and Medical Research New South Wales Health Pathology Westmead Hospital The Marie Bashir Institute for Infectious Diseases and Biosecurity University of Sydney Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C. 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