Table 1.
Baseline clinical characteristics and risk factors for increasing antigenemia of HCT recipients by response
| Patient characteristic | Paradoxical respondersa | Nonparadoxical respondersb | P value |
|---|---|---|---|
| Median age [yr (range)] | 47 (20–63) | 42 (16–70) | 0.70 |
| No. (%) of males | 11 (48) | 46 (62) | 0.22 |
| No. (%) with diagnosis of: | 0.73 | ||
| Acute myeloid leukemia | 11 (48) | 36 (49) | |
| Acute lymphoblastic leukemia | 4 (17) | 16 (22) | |
| Chronic myeloid leukemia | 0 | 1 (1) | |
| Aplastic anemia | 2 (9) | 9 (12) | |
| Myelodysplastic syndrome | 5 (22) | 6 (8) | |
| Non-Hodgkin lymphoma | 1 (4) | 5 (7) | |
| Paroxysmal nocturnal hemoglobinuria | 0 | 1 (1) | |
| No. (%) whose underlying disease was: | |||
| Hypertension | 22 (96) | 60 (81) | 0.11 |
| Diabetes mellitus | 1 (4) | 6 (8) | >0.99 |
| Hemodialysis | 0 | 1 (1) | >0.99 |
| Heart failure | 0 | 3 (4) | >0.99 |
| Solid tumor | 1 (4) | 1 (1) | 0.42 |
| No. (%) with following transplant type: | 0.08 | ||
| Allogeneic, sibling | 9 (39) | 24 (32) | |
| Allogeneic, family donor other than sibling | 11 (48) | 22 (30) | |
| Allogeneic, unrelated | 3 (13) | 28 (38) | |
| No. (%) whose stem cell source was: | 0.95 | ||
| Bone marrow | 3 (13) | 10 (13.5) | |
| Peripheral blood | 20 (87) | 64 (87.5) | |
| No. (%) whose conditioning regimen was: | 0.15 | ||
| Cyclophosphamide + ATG | 0 | 4 (5) | |
| Busulfan + cyclophosphamide | 2 (9) | 7 (10) | |
| Cyclophosphamide + fludarabine + ATG | 1 (4) | 2 (3) | |
| Busulfan + fludarabine + ATG | 19 (83) | 52 (70) | |
| Other | 1 (4) | 9 (12) | |
| No. (%) of donors CMV serology positive | 23 (100) | 73 (99) | >0.99 |
| No. (%) of recipients CMV serology positive | 23 (100) | 74 (100) | >0.99 |
| Median WBC count/mm3 before GCV treatment (IQR) | 2,700 (1,500–3,700) | 3,900 (2,175–5,800) | 0.02 |
| Median hemoglobin level (g/dl) before GCV treatment (IQR) | 9.9 (8.9–11.3) | 10.1 (9.1–11.2) | 0.89 |
| Median platelet count (103/mm3) before GCV treatment (IQR) | 108 (44–166) | 114 (31–183) | 0.79 |
| Median baseline antigenemia level (IQR) | 14 (6–77) | 23 (6–86) | 0.96 |
| Median duration of antigenemia positivity prior to antiviral therapy (IQR) | 7.0 (0–14) | 0 (0–7) | 0.04 |
| No. (%) who received preemptive GCV therapy | 0.63 | ||
| Low dose | 14 (61) | 39 (53) | |
| Conventional dose | 9 (39) | 35 (47) | |
| Immunosuppressed status | |||
| Median change in cyclosporine at first antigenemia (IQR) | 69 (53–72) | 69 (49–89) | 0.84 |
| Median no. of mg of ATG used (IQR) | 175 (150–199) | 180 (160–220) | 0.83 |
| No. (%) using steroids at: | |||
| 0 mg/kg | 14 (60) | 37 (50) | 0.85 |
| <1 mg/kg | 5 (22) | 20 (27) | |
| 1-2 mg/kg | 2 (9) | 9 (12) | |
| ≥2 mg/kg | 2 (9) | 8 (11) | |
| No. (%) who experienced GVHD in first 100 days | 10 (44) | 36 (49) | 0.66 |
| No. (%) with GVHD | 0.41 | ||
| Grade 1 | 1 (10) | 3 (8) | |
| Grade 2 | 5 (50) | 12 (33) | |
| Grade 3 | 2 (20) | 11 (31) | |
| Grade 4 | 2 (20) | 10 (28) |
a
Total n = 23.
b
Total n = 74.