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Cytomegalovirus infection does not impact on survival or time to first treatment in patients with Chronic Lymphocytic Leukaemia

Parry, Helen Marie, Damery, Sarah, Hudson, Christopher, Maurer, Matthew J., Cerhan, James R., Pachnio, Annette, Begum, Jusnara, Slager, Susan L., Fegan, Christopher Daniel, Man, Stephen, Pepper, Christopher John, Shanafelt, Tait D., Pratt, Guy and Moss, Paul A. H. 2016. Cytomegalovirus infection does not impact on survival or time to first treatment in patients with Chronic Lymphocytic Leukaemia. American Journal of Hematology 91 (8) , pp. 776-781. 10.1002/ajh.24403

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Abstract

Human cytomegalovirus (HCMV) is a widely prevalent herpes virus which establishes a state of chronic infection. The establishment of CMV‐specific immunity controls viral reactivation and leads to the accumulation of very large numbers of virus‐specific T cells which come to dominate the immune repertoire. There is concern that this may reduce the immune response to heterologous infections and HCMV infection has been associated with reduced survival in elderly people. Patients with chronic lymphocytic leukemia (B‐CLL) suffer from a state of immune suppression but have a paradoxical increase in the magnitude of the CMV‐specific T cell and humoral immune response. As such, there is now considerable interest in how CMV infection impacts on the clinical outcome of patients with B‐CLL. Utilizing a large prospective cohort of patients with B‐CLL (n = 347) we evaluated the relationship between HCMV seropositivity and patient outcome. HCMV seropositive patients had significantly worse overall survival than HCMV negative patients in univariate analysis (HR = 2.28, 95% CI: 1.34–3.88; P = 0.002). However, CMV seropositive patients were 4 years older than seronegative donors and this survival difference was lost in multivariate modeling adjusted for age and other validated prognostic markers (P = 0.34). No significant difference was found in multivariate modeling between HCMV positive and negative patients in relation to the time to first treatment (HR = 1.12, 95% CI: 0.68–1.84; P = 0.65). These findings in a second independent cohort of 236 B‐CLL patients were validated. In conclusion no evidence that HCMV impacts on the clinical outcome of patients with B‐CLL was found.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Publisher: Wiley-Blackwell
ISSN: 0361-8609
Date of First Compliant Deposit: 22 August 2017
Date of Acceptance: 25 April 2016
Last Modified: 18 Jun 2019 10:30
URI: http://orca.cf.ac.uk/id/eprint/90855

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