{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:11:55Z","timestamp":1793081515220,"version":"4.5.0"},"reference-count":47,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hematopoietic stem cell transplantation (HSCT) is a curative therapy for an increasing number of nonmalignant indications. Its use is restricted by severe transplant-related complications, including CMV infection; despite various prophylactic and therapeutic strategies, CMV reactivation has remarkable morbidity and mortality. The analysis included 94 children with nonmalignant disorder who underwent allogeneic HSCT in the Department of Pediatric Hematology, Oncology, and Bone Marrow Transplantation in Wroc\u0142aw during years 2016\u20132020. Twenty-seven (29%) children presented with CMV infection, including ten (10\/27; 37%) with high level CMV viremia (10,000 copies\/mL). Six patients experienced subsequent CMV reactivation. The first-line ganciclovir-based (GCV) treatment was insufficient in 40% (11\/27) of children. Overall survival (OS) was significantly lower in children with high CMV viremia compared to those with low levels\/no CMV [1yrOS High CMV = 0.80 (95% CI 0.41\u20130.95) vs. 1yrOS others = 0.96 (95% CI 0.89\u20130.99)]. Similarly, patients with resistant and recurrent infections had greater risk of death. CMV reactivation at any level relevantly prolonged the hospital stay. CMV reactivation with high viremia load and resistant\/recurrent CMV infections lead to a significant decrease in OS in children with nonmalignant disorders treated with HSCT. Our data proves there is an urgent need to introduce an effective anti-CMV prophylaxis in this cohort of patients.<\/jats:p>","DOI":"10.3390\/jcm11175187","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T21:27:17Z","timestamp":1662067637000},"page":"5187","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Impact of High CMV Viral Load and Refractory CMV Infection on Pediatric HSCT Recipients with Underlying Non-Malignant Disorder"],"prefix":"10.3390","volume":"11","author":[{"given":"Zofia","family":"Szmit","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jowita","family":"Fr\u0105czkiewicz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Salamonowicz-Bodzioch","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kr\u00f3l","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5725-4835","authenticated-orcid":false,"given":"Marek","family":"Ussowicz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Mielcarek-Siedziuk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolina","family":"Liszka","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawe\u0142","family":"Marschollek","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewa","family":"Gorczy\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Ka\u0142wak","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology and BMT, Wroclaw Medical University, Supraregional Center of Pediatric Oncology \u201cCape of Hope\u201d, 50-556 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1038\/s41409-019-0465-9","article-title":"The EBMT activity survey report 2017: A focus on allogeneic HCT for nonmalignant indications and on the use of non-HCT cell therapies","volume":"54","author":"Passweg","year":"2019","journal-title":"Bone Marrow Transplant."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1542\/pir.2015-0044","article-title":"Hematopoietic Stem Cell Transplantation in Children and Adolescents","volume":"37","author":"Guilcher","year":"2016","journal-title":"Pediatr. 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