{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:29:42Z","timestamp":1787761782950,"version":"build-2784847793"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Human cytomegalovirus (CMV) is a major source of morbidity and mortality in pediatric hematopoietic stem cell transplantation (HSCT). CMV replication is mainly controlled by T-cell-mediated immunity. Despite treatment, CMV reactivation continues to have a significant adverse impact on post-transplant outcomes. In this study, we examine the clinical aspects and risk factors for CMV reactivation and disease, and the effect of therapeutic interventions in pediatric patients who underwent HSCT.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    This retrospective, single-center study included pediatric patients who underwent haploidentical HSCT at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia, from 2013 to 2018.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    A total of 94 HSCT recipients were included: 46 (48.94%) females and 48 (51.06%) males, with a median age of 5 years [interquartile range (IQR): 1.2\u20138.7]. As for donors, 57 (60.64%) were males and 37 (39.36%) were females, with a median age of 30.7 years (IQR: 23.0\u201335.3). CMV reactivation occurred in 52 (55.32%) of the HSCT patients. The overall mortality rate was 12.77% (12\/94), and of those, 83.33% (10\/12) were CMV positive. However, no patient developed CMV pneumonitis, gastritis, or colitis, and CMV was not identified as the direct cause of death. Regarding CMV risk factors, higher recipient age and the presence of acute graft-versus-host disease were significantly associated with CMV reactivation (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    &lt; 0.05).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Preventing CMV infection significantly impacts the post-transplant course, especially in the setting of mismatched donors. This study showed that preventing CMV by preemptive therapy revealed an undetectable rate of 78.85%. Current polymerase chain reaction (PCR)-directed surveillance and prophylaxis have lowered the incidence of CMV disease and persistent DNAemia.\n                  <\/jats:p>","DOI":"10.4103\/hemoncstem.hemoncstem-d-24-00044","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:00:35Z","timestamp":1753696835000},"page":"86-92","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Cytomegalovirus infection in pediatric haploidentical stem cell transplantation"],"prefix":"10.4103","volume":"18","author":[{"given":"Abdulrahman","family":"AlSweed","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suliman","family":"Aljumaah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawazen","family":"AlSaedi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology\/Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hibah","family":"Alruwaisan","sequence":"additional","affiliation":[{"name":"Antimicrobial stewardship pharmacy specialist, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Alhuthil","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Al-Hajjar","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Infectious Disease, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"issue":"(3)","key":"R1-20250728","doi-asserted-by":"crossref","first-page":"237","DOI":"10.5581\/1516-8484.20110060","article-title":"Advances in haploidentical stem cell transplantation","volume":"33","author":"Bayraktar","year":"2011","journal-title":"Revista Brasileira de Hematologia e Hemoterapia"},{"issue":"(4)","key":"R2-20250728","doi-asserted-by":"crossref","first-page":"665","DOI":"10.5500\/wjt.v6.i4.665","article-title":"Overview of the progress on haploidentical hematopoietic transplantation","volume":"6","author":"Farhadfar","year":"2016","journal-title":"World Journal of Transplantation"},{"issue":"(6)","key":"R3-20250728","doi-asserted-by":"crossref","first-page":"2219","DOI":"10.1128\/JCM.39.6.2219-2226.2001","article-title":"Characterization of human cytomegalovirus strains by analysis of short tandem repeat polymorphisms","volume":"39","author":"Walker","year":"2001","journal-title":"J Clin Microbiol"},{"key":"R4-20250728","first-page":"ciw668","article-title":"Disease Definitions Working Group of the Cytomegalovirus Drug Development Forum. Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials","author":"Ljungman","year":"2016","journal-title":"Clin Infect Dis"},{"issue":"(1)","key":"R5-20250728","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.hoc.2010.11.011","article-title":"Cytomegalovirus in hematopoietic stem cell transplant recipients","volume":"25","author":"Ljungman","year":"2011","journal-title":"Hematol\/Oncol Clin N Am"},{"issue":"(1)","key":"R6-20250728","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3324\/haematol.2019.227371","article-title":"Impact of graft composition on outcomes of haploidentical bone marrow stem cell transplantation","volume":"106","author":"Saliba","year":"2020","journal-title":"Haematologica"},{"issue":"(1)","key":"R7-20250728","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1038\/s41467-022-29943-9","article-title":"Immunoprofiling reveals cell subsets associated with the trajectory of cytomegalovirus reactivation post stem cell transplantation","volume":"13","author":"Stern","year":"2022","journal-title":"Nat Commun"},{"issue":"(2)","key":"R8-20250728","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1038\/sj.bmt.1705699","article-title":"Risk factors associated with late cytomegalovirus reactivation after allogeneic stem cell transplantation for hematological malignancies","volume":"40","author":"\u00d6zdemir","year":"2007","journal-title":"Bone Marrow Transplant"},{"issue":"(4)","key":"R9-20250728","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1093\/cid\/ciu364","article-title":"Donor cytomegalovirus status influences the outcome of allogeneic stem cell transplant: a study by the European Group for Blood and Marrow Transplantation","volume":"59","author":"Ljungman","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"(13)","key":"R10-20250728","doi-asserted-by":"crossref","first-page":"4255","DOI":"10.1182\/blood-2002-10-3263","article-title":"Donor CMV serologic status and outcome of CMV-seropositive recipients after unrelated donor stem cell transplantation: an EBMT megafile analysis","volume":"102","author":"Ljungman","year":"2003","journal-title":"Blood"},{"key":"R11-20250728","doi-asserted-by":"crossref","first-page":"2016031","DOI":"10.4084\/mjhid.2016.031","article-title":"CMV in hematopoietic stem cell transplantation","volume":"8","author":"De la Camara","year":"2016","journal-title":"Mediterr J Hematol Infect Dis"},{"issue":"(2)","key":"R12-20250728","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/sj.bmt.1704543","article-title":"Risk factors for post-engraftment invasive aspergillosis in allogeneic stem cell transplantation","volume":"34","author":"Thursky","year":"2004","journal-title":"Bone Marrow Transplant"},{"issue":"(7)","key":"R13-20250728","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1038\/sj.bmt.1702226","article-title":"Risk factors for treatment failures in patients receiving PCR-based preemptive therapy for CMV infection","volume":"25","author":"Einsele","year":"2000","journal-title":"Bone Marrow Transplant"},{"issue":"(5)","key":"R14-20250728","doi-asserted-by":"crossref","first-page":"466","DOI":"10.2174\/187152611797636703","article-title":"Overview of the diagnosis of cytomegalovirus infection","volume":"11","author":"Ross","year":"2011","journal-title":"Infect Disord Drug Targets"},{"issue":"(3)","key":"R15-20250728","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1038\/s41409-023-01920-w","article-title":"Cytomegalovirus breakthrough and resistance during letermovir prophylaxis","volume":"58","author":"Perchetti","year":"2023","journal-title":"Bone Marrow Transplant"},{"issue":"(4)","key":"R16-20250728","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1093\/cid\/ciab988","article-title":"Maribavir for refractory cytomegalovirus infections with or without resistance post-transplant: results from a phase 3 randomized clinical trial","volume":"75","author":"Avery","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"(2)","key":"R17-20250728","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.bbmt.2017.09.018","article-title":"Prevention of cytomegalovirus reactivation in haploidentical stem cell transplantation","volume":"24","author":"Hammerstrom","year":"2018","journal-title":"Biol Blood Marrow Transplant"},{"issue":"(4)","key":"R18-20250728","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/j.bbmt.2017.11.038","article-title":"Impact of cytomegalovirus viral load on probability of spontaneous clearance and response to preemptive therapy in allogeneic stem cell transplantation recipients","volume":"24","author":"Camargo","year":"2018","journal-title":"Biol Blood Marrow Transplant"},{"issue":"(9)","key":"R19-20250728","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1093\/jpids\/piab041","article-title":"Incidence of CMV infection and disease and adverse events associated with antiviral therapy in a retrospective cohort of allogeneic hematopoietic cell transplant recipients at an academic children\u2019s hospital","volume":"10","author":"Hayes","year":"2021","journal-title":"J Pediatr Infect Dis Soc"},{"key":"R20-20250728","doi-asserted-by":"crossref","first-page":"1027341","DOI":"10.3389\/fcimb.2022.1027341","article-title":"Features of cytomegalovirus infection and evaluation of cytomegalovirus-specific T cells therapy in children\u2019s patients following allogeneic hematopoietic stem cell transplantation: a retrospective single-center study","volume":"12","author":"Ruan","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"issue":"(6)","key":"R21-20250728","doi-asserted-by":"crossref","first-page":"e15375","DOI":"10.1111\/ctr.15375","article-title":"Clinical and economic impact of CMV infection in allogeneic hematopoietic stem cell transplantation: perspectives from a middle\u2010income nation","volume":"38","author":"Gan","year":"2024","journal-title":"Clin Transplant"},{"issue":"(4)","key":"R22-20250728","doi-asserted-by":"crossref","first-page":"e14083","DOI":"10.1111\/tid.14083","article-title":"Epidemiology, treatment patterns, and disease burden of cytomegalovirus in hematopoietic cell transplant recipients in selected countries outside of Europe and North America: a systematic review","volume":"25","author":"Cho","year":"2023","journal-title":"Transpl Infect Dis"},{"issue":"(4)","key":"R23-20250728","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1097\/MPH.0000000000000730","article-title":"Cytomegalovirus treatment in pediatric hematopoietic stem cell transplant patients","volume":"39","author":"Wattles","year":"2017","journal-title":"J Pediatr Hematol Oncol"}],"container-title":["Hematology\/Oncology and Stem Cell Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.HEMONCSTEM-D-24-00044","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T16:05:36Z","timestamp":1787760336000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/hemoncstem.HEMONCSTEM-D-24-00044"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/hemoncstem.hemoncstem-d-24-00044","relation":{},"ISSN":["1658-3876","2589-0646"],"issn-type":[{"value":"1658-3876","type":"print"},{"value":"2589-0646","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-10-14","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}