{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:36:42Z","timestamp":1791905802370,"version":"4.3.4"},"reference-count":26,"publisher":"American Society of Hematology","issue":"8","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The kinetics of early and late cytomegalovirus (CMV) reactivation after hematopoietic cell transplantation using various methods of graft-versus-host-disease (GVHD) prophylaxis are poorly defined. We retrospectively compared CMV reactivation and disease among 780 seropositive patients given HLA-matched peripheral blood stem cell (PBSC) grafts and calcineurin inhibitor plus posttransplantation cyclophosphamide (PTCy; n\u00a0= 44), mycophenolate mofetil (MMF; n\u00a0= 414), or methotrexate (MTX; n\u00a0= 322). Transplantation occurred between 2007 and 2018; CMV monitoring\/management followed uniform standard practice. Hazards of CMV reactivation at various thresholds were compared. Spline curves were fit over average daily viral load and areas under the curve (AUC) within 1 year were calculated. PTCy and MMF were associated with an increased risk of early (day \u2264100) CMV reactivation \u2265250 IU\/mL after multivariate adjustment. The viral load AUC at 1 year was highest with MMF (mean difference\u00a0= 0.125 units vs MTX group) and similar between PTCy and MTX (mean difference\u00a0= 0.016 units vs MTX group). CMV disease risk was similar across groups. There was no interaction between GVHD prophylaxis and CMV reactivation on chronic GVHD risk. Despite PTCy-associated increased risk of early CMV reactivation, the CMV disease risk by 1 year was low in HLA-matched PBSC transplant recipients. In contrast, MMF was associated with higher overall CMV viral burden in the 1 year posttransplant. Although different mechanisms of immunosuppressive agents may affect CMV reactivation risk, effective prevention of GVHD may reduce corticosteroid exposure and mitigate infection risk over time.<\/jats:p>","DOI":"10.1182\/bloodadvances.2022009112","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T17:57:47Z","timestamp":1672768667000},"page":"1394-1403","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":28,"title":["Impact of GVHD prophylaxis on CMV reactivation and disease after HLA-matched peripheral blood stem cell transplantation"],"prefix":"10.1182","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-1976","authenticated-orcid":false,"given":"Masumi","family":"Ueda Oshima","sequence":"first","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"2Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0556-6591","authenticated-orcid":false,"given":"Hu","family":"Xie","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1318-2902","authenticated-orcid":false,"given":"Danniel","family":"Zamora","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"3Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Flowers","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"2Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey R.","family":"Hill","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"2Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco B.","family":"Mielcarek","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"2Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9767-9739","authenticated-orcid":false,"given":"Brenda M.","family":"Sandmaier","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"2Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ted A.","family":"Gooley","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1538-7984","authenticated-orcid":false,"given":"Michael J.","family":"Boeckh","sequence":"additional","affiliation":[{"name":"1Fred Hutchinson Cancer Center, Seattle, WA"},{"name":"3Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"issue":"12","key":"2023042114594994800_bib1","doi-asserted-by":"crossref","first-page":"3456","DOI":"10.1182\/blood.V98.12.3456","article-title":"Durable engraftment of major histocompatibility complex-incompatible cells after nonmyeloablative conditioning with fludarabine, low-dose total body irradiation, and posttransplantation cyclophosphamide","volume":"98","author":"Luznik","year":"2001","journal-title":"Blood"},{"issue":"11","key":"2023042114594994800_bib2","doi-asserted-by":"crossref","first-page":"1502","DOI":"10.1182\/blood-2015-10-672071","article-title":"Posttransplantation cyclophosphamide for prevention of graft-versus-host disease after HLA-matched mobilized blood cell transplantation","volume":"127","author":"Mielcarek","year":"2016","journal-title":"Blood"},{"issue":"3","key":"2023042114594994800_bib3","doi-asserted-by":"crossref","first-page":"S375","DOI":"10.1016\/j.bbmt.2015.11.887","article-title":"Viral reactivation in haploidentical transplants using post-transplantation cyclophosphamide - 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