Table 1.
Comparison of the characteristics of tissue-invasive CMV disease in KT and allogeneic HCT recipients during preemptive therapy
| Characteristic | KT (n = 27) | HCT (n = 21) | p valuea |
|---|---|---|---|
| Age, yr, median (IQR) | 55 (45–58) | 50 (36–54) | 0.07 |
| Male sex | 14 (52) | 13 (62) | 0.56 |
| Incidence, /100 person-year (95% CI) | 4.1 (2.7–6.0) | 5.0 (3.1–7.7) | 0.49 |
| Absolute neutrophil count at the onset time, median (IQR), µg/L | 3,771 (2,645–5,333) | 2,332 (1,411–4,560) | 0.01 |
| Absolute neutrophil count < 1,000 | 1 (4) | 1 (5) | > 0.99 |
| Time of initial episode from transplantation, median (IQR), day | 51 (35–88) | 60 (40–115) | 0.30 |
| More than 100 days post-transplantation | 4 (15) | 8 (38) | 0.10 |
| More than 180 days post-transplantation | 2 (7) | 0 | 0.50 |
| Peak level of CMV antigenemia, median (IQR), /200,000 cells | 343 (98–1,078) | 81 (35–1,301) | 0.13 |
| Preceding CMV antigenemia, median (IQR), /200,000 cells | 190 (15–385) | 6 (3–11) | < 0.001 |
| With significant preceding CMV antigenemiab | 16 (59) | 7 (33) | 0.008 |
| Without preceding CMV antigenemia | 4 (15) | 8 (38) | 0.10 |
| Without concurrent CMV antigenemia | 4 (15) | 5 (24) | 0.48 |
| Type of infection | |||
| Gastrointestinal disease | 26 (96) | 17 (81) | 0.15 |
| Retinitis | 0 | 4 (19)c | 0.03 |
| Pneumonia | 1 (4) | 2 (10) | 0.57 |
| Recurrent CMV infection after CMV disease | 2 (7) | 5 (24) | 0.22 |
| Recurrent CMV disease | 0 | 2 (10) | 0.19 |
| CMV disease following successful ganciclovir therapy (group B) | 0 | 11 (52) | < 0.001 |
| Breakthrough CMV diseased | 3 (11) | 2 (10) | > 0.99 |
| Overall mortality | 2 (7) | 8 (38) | 0.01 |
Values are presented as number (%) of patients unless otherwise indicated.
CMV, cytomegalovirus; KT, kidney transplant; HCT, hematopoietic stem cell transplant; IQR, interquartile range; CI, confidence interval.
Fisher exact test for categorical variables, Mann-Whitney U test for continuous variables, and the Poisson distribution for incidence rates were used to compare.
Significant CMV antigenemia was defined as the level of CMV antigenemia ≥ 50/200,000 cells in KT and ≥ 50/200,000 cells in HCT.
Of the four patients, one had concurrent CMV retinitis with gastrointestinal CMV disease.
Breakthrough CMV disease was defined as the occurrence of CMV disease more than 7 days after ganciclovir or valganciclovir therapy in patients who did not have any symptoms and signs at the time of the start of antiviral therapy.