Table 1.
Demographic and clinical variables at the time of the BAL
| Negative HHV-6B DNA in BAL (N = 71) |
Positive HHV6-B DNA in BAL (any level) (N = 42)a | Positive HHV6-B DNA in BAL ≥ 2.3 log10 copies/mL (N = 27)a | Total (N = 113b) | |
|---|---|---|---|---|
| Age, years | ||||
| <=20 | 0 (0%) | 1 (2%) | 1 (4%) | 1 (1%) |
| 21–40 | 17 (24%) | 15 (36%) | 10 (37%) | 32 (28%) |
| 41–60 | 27 (38%) | 10 (24%) | 6 (22%) | 37 (33%) |
| >60 | 27 (38%) | 16 (38%) | 10 (37%) | 43 (38%) |
| Female sex | 27 (38%) | 22 (52%) | 13 (48%) | 49 (43%) |
| Race | ||||
| Caucasian | 53 (75%) | 33 (79%) | 20 (74%) | 86 (76%) |
| Non-Caucasian | 15 (21%) | 9 (21%) | 7 (26%) | 24 (21%) |
| Unknown | 3 (4%) | 0 (0%) | 0 (0%) | 3 (3%) |
| Year of HCT | ||||
| 2015 | 6 (8%) | 0 (0%) | 0 (0%) | 6 (5%) |
| 2016 | 12 (17%) | 5 (12%) | 4 (15%) | 17 (15%) |
| 2017 | 22 (31%) | 16 (38%) | 11 (41%) | 38 (34%) |
| 2018 | 18 (25%) | 7 (17%) | 5 (19%) | 25 (22%) |
| 2019 | 13 (18%) | 14 (33%) | 7 (26%) | 27 (24%) |
| Center | ||||
| City of Hope | 20 (28%) | 16 (38%) | 9 (33%) | 36 (32%) |
| Fred Hutch | 46 (65%) | 24 (57%) | 17 (63%) | 70 (62%) |
| MSKCC | 5 (7%) | 2 (5%) | 1 (4%) | 7 (6%) |
| CMV serostatus | ||||
| D- and R- | 10 (14%) | 4 (10%) | 3 (11%) | 14 (12%) |
| D+ or R+ | 61 (86%) | 36 (86%) | 22 (81%) | 97 (86%) |
| Missing | 0 (0%) | 2 (5%) | 2 (7%) | 2 (2%) |
| HCT comorbidity index scorec | ||||
| 0 (low) | 8 (11%) | 3 (7%) | 3 (11%) | 11 (10%) |
| 1–2 (intermediate) | 20 (28%) | 11 (26%) | 8 (30%) | 31 (27%) |
| >=3 (high) | 43 (61%) | 28 (67%) | 16 (59%) | 71 (63%) |
| HLA D/R status | ||||
| Matched related | 9 (13%) | 7 (17%) | 6 (22%) | 16 (14%) |
| Matched unrelated | 26 (37%) | 14 (33%) | 6 (22%) | 40 (35%) |
| Mismatched related | 11 (15%) | 8 (19%) | 7 (26%) | 19 (17%) |
| Mismatched unrelated | 24 (34%) | 12 (29%) | 7 (26%) | 36 (32%) |
| Missing | 1 (1%) | 1 (2%) | 1 (4%) | 2 (2%) |
| Donor cell source | ||||
| Peripheral blood | 51 (72%) | 33 (79%) | 18 (67%) | 84 (74%) |
| Bone marrow | 16 (23%) | 7 (17%) | 7 (26%) | 23 (20%) |
| Umbilical cord blood | 4 (6%) | 2 (5%) | 2 (7%) | 6 (5%) |
| Myeloablative conditioningd | 32 (45%) | 14 (33%) | 10 (37%) | 46 (41%) |
| Maximum corticosteroid use pre-BALe | ||||
| None | 39 (55%) | 17 (40%) | 11 (41%) | 56 (50%) |
| <1 mg/kg/day | 13 (18%) | 18 (43%) | 12 (44%) | 31 (27%) |
| ≥1 mg/kg/day | 19 (27%) | 7 (17%) | 4 (15%) | 26 (23%) |
| Maximum oxygen use pre-BAL > 2 L/minf | 30 (42%) | 21 (50%) | 14 (52%) | 51 (45%) |
| WBC count pre-BALg | ||||
| >1000 cells/mm3 | 50 (70%) | 31 (74%) | 7 (26%) | 81 (72%) |
| ≤1000 cells/mm3 | 17 (24%) | 10 (24%) | 19 (70%) | 27 (24%) |
| Missing | 4 (6%) | 1 (2%) | 1 (4%) | 5 (4%) |
| ALC pre-BALg | ||||
| >300 cells/mm3 | 27 (38%) | 11 (26%) | 17 (63%) | 38 (34%) |
| ≤300 cells/mm3 | 33 (46%) | 26 (62%) | 7 (26%) | 59 (52%) |
| Missing | 11 (15%) | 5 (12%) | 3 (11%) | 16 (14%) |
| ANC pre-BALg | ||||
| >500 cells/mm3 | 48 (68%) | 29 (69%) | 17 (63%) | 77 (68%) |
| ≤500 cells/mm3 | 12 (17%) | 8 (19%) | 7 (26%) | 20 (18%) |
| Missing | 11 (15%) | 5 (12%) | 3 (11%) | 16 (14%) |
| Day of BAL post-HCT (median, IQR) | 37 (15-68) | 42 (20–79) | 31 (20–72) | 37 (19–76) |
| Antiviral therapy at time of sample collectionh | 24 (34%) | 12 (29%) | 6 (22%) | 36 (32%) |
| LRTD causei | ||||
| Bacterial | 7 (10%) | 3 (7%) | 2 (7%) | 10 (9%) |
| Viral | 12 (17%) | 6 (14%) | 3 (11%) | 18 (16%) |
| Fungal | 16 (23%) | 10 (24%) | 8 (30%) | 26 (23%) |
| IPS | 14 (20%) | 4 (10%) | 4 (15%) | 18 (16%) |
| Other | 9 (13%) | 2 (5%) | 0 (0%) | 11 (10%) |
| Multifactorial | 13 (18%) | 17 (40%) | 10 (37%) | 30 (27%) |
Data are presented as number (percentage), unless otherwise indicated.
HHV-6B human herpesvirus 6B, BAL bronchoalveolar lavage, D donor, R recipient, HLA human leukocyte antigen, D donor, R recipient, WBC white blood cell, ALC absolute lymphocyte count, ANC absolute neutrophil count, LRTD lower respiratory tract disease, IPS idiopathic pneumonia syndrome.
aGroups are not mutually exclusive.
b3 of the 116 enrolled participants did not have a BAL fluid sample available for testing and are excluded from this Table and from the analyses that incorporate BAL fluid HHV-6B test results.
cBased on the HCT-comorbidity index.
dMyeloablative regimens included any regimen containing ≥800 cGY TBI, any regimen containing carmustine/etoposide/cytarabine/melphalan (BEAM), or any regimen containing busulfan/cyclophosphamide with or without antithymocyte globulin.
eWithin 14 days pre-BAL, based on prednisone-equivalent dosing.
fWithin 24 h preceding the BAL.
gClosest sample within 3 days pre-BAL.
hGanciclovir, foscarnet, or cidofovir for CMV or adenovirus.
iAdditional details on specific causes are in Table S1.