{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:25:36Z","timestamp":1781868336475,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,5,18]],"date-time":"2021-05-18T00:00:00Z","timestamp":1621296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Few studies have compared the clinical impact of multiple DNA\u2010virus infections in haploidentical hematopoietic stem cell transplantation (haplo\u2010HSCT) with posttransplant cyclophosphamide (PTCy) and unrelated donor allogeneic hematopoietic stem cell transplantation (UD\u2010HSCT) with thymoglobulin, so we retrospectively analyzed viral infections in the first 6\u00a0mo posttransplant in these scenarios. Fifty\u2010nine patients underwent to haplo\u2010HSCT, and 68 to UD\u2010HSCT. The most frequent infection was cytomegalovirus (CMV) (76.3% in haplo\u2010HSCT and 69.1% in UD\u2010HSCT) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.878) and in the group of patients with CMV reactivation, maximal CMV viral load over 2500\u00a0UI\/ml correlated with worse overall survival\u2010hazard ratio (HR) 1.93 (95% confidence interval [CI] 1.04\u20103.59) <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03. The cumulative incidence of multiple DNA virus within 180\u00a0d of posttransplant was 78.7% for one virus and 28.4% for two or more viruses with no difference regarding the type of transplant. Viral infections, age, and acute graft versus host disease (GVHD) grades II\u2013IV were risk factors for worse overall survival in multivariate analyses: one virus HR 2.53 (95% CI 1.03\u20106.17) <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04, two or more viruses HR 3.51 (95% CI 1.37\u20109) <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01, age HR 1.03 (95% CI 1.02\u20101.05) <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01 and acute GVHD II\u2013IV HR 1.97 (95% CI 1.13\u20103.43) <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01. Also, age over 50\u00a0y HR 4.25 (95% CI 2.01\u20108.97) <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, second CMV reactivation or having both CMV and BK polyomavirus (BKV) HR 2.65 (95% CI 1.26\u20105.56) <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01 and acute GVHD grades II\u2013IV HR 2.23 (95% CI 1.12\u20104.43) <jats:italic>P<\/jats:italic>\u00a0=\u00a0.022 were risk factors for nonrelapse mortality in the multivariate analyses. In conclusion, multiple DNA\u2010virus infections are frequent in both haplo\u2010HSCT and UD\u2010HSCT and a risk factor for worse overall survival.<\/jats:p>","DOI":"10.1111\/tid.13626","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T10:21:40Z","timestamp":1619432500000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical impact of multiple DNA virus infections in nondepleted haploidentical and unrelated allogeneic hematopoietic stem cell transplantation"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4441-9212","authenticated-orcid":false,"given":"Mariana N.","family":"Kerbauy","sequence":"first","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreza A. F.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo J.","family":"Arcuri","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucila N.","family":"Kerbauy","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinthya C.","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Fernando A.","family":"Camargo","sequence":"additional","affiliation":[{"name":"Instituto Israelita de Ensino e Pesquisa (IIEP) Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"},{"name":"Department of Infectious Diseases Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"},{"name":"Department of Infectious Diseases Universidade Federal de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1417-0249","authenticated-orcid":false,"given":"Clarisse M.","family":"Machado","sequence":"additional","affiliation":[{"name":"Instituto Israelita de Ensino e Pesquisa (IIEP) Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"},{"name":"Virology Laboratory Institute of Tropical Medicine University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Hamerschlak","sequence":"additional","affiliation":[{"name":"Department of Hematology and Bone Marrow Transplantation Hospital Israelita Albert Einstein S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-02-514760"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-10-748426"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1703351"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.03.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810223391702"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.09.117"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2008.03.005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.01.006"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2012.07.003"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-015-2423-y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2015.09.001"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.12.001"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw668"},{"issue":"1","key":"e_1_2_9_15_1","first-page":"12","article-title":"ECIL guidelines for the prevention, diagnosis and treatment of BK polyomavirus\u2010associated haemorrhagic cystitis in haematopoietic stem cell transplant recipients","volume":"73","author":"Cesaro S","year":"2018","journal-title":"J Antimicrob Chemother"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(19)30256-X"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13096"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019000956"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2010.11.011"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/375075"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-3062.1999.010305.x"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.08.003"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.13206"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020009362"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12629"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.149880"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(15)00289-6"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2017.11.038"},{"issue":"1","key":"e_1_2_9_29_1","first-page":"78","article-title":"Risk factors for the development of cytomegalovirus disease after allogeneic stem cell transplantation","volume":"91","author":"Ljungman P","year":"2006","journal-title":"Haematologica"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2010.03.020"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2016.216"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704164"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2006-03-011791"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.5114\/ceji.2016.63129"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.12.753"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1086\/428060"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3046.2009.01226.x"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13626","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.13626","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T11:18:41Z","timestamp":1693221521000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.13626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,18]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/tid.13626"],"URL":"https:\/\/doi.org\/10.1111\/tid.13626","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,18]]},"assertion":[{"value":"2020-11-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13626"}}