1356. Cytomegalovirus Disease in Patients with Hematological Malignancies: Identifying Risk Factors
Session: Poster Abstract Session: Clinical Trials
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • CMVposterfinal.pdf (159.6 kB)
  • Background: CMV disease (CMVD) is well described in solid organ (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Although CMVD has been increasingly reported among patients with hematologic malignancies (HM), the associated risk factors in this population have not been well described in case-control studies.

    Methods: Adult patients discharged from our institution between January 1, 2000 and October 31, 2012 with a diagnosis of CMVD were screened for inclusion.  Patients with any underlying HM were included in the final analysis as cases.  SOT, HSCT, and HIV-positive patients were excluded.  CMVD was accepted as a diagnosis if viral inclusions were identified on tissue biopsy, or if serum CMV PCR or tissue cultures were positive in the presence of clinical or radiographic evidence of end organ damage.  Control patients were identified from the Oncology clinic records and matched in a 4:1 fashion with cases based on the HM type. All data will be analyzed using SPSS v. 21.0 and a p-value of 0.05 or less will be considered to indicate statistical significance.

    Results:

    Six patients with HM (CLL in 2 and NHL in 4) and CMVD were identified; CMVD colitis (n=3), pneumonitis (n=2), and retinitis (n=1).  Case patients were matched with 24 HM patients without CMVD.  Treatment data was available for 5 case patients only.  These patients received ganciclovir, valganciclovir or both for a mean of 5±6.6 months.  One case patient died due to CMVD within the first 6 months of CMVD diagnosis.

    There was a significant difference between cases and controls with respect to mean age [69.3±5.4 vs 60.3±10.2 years, respectively (p=0.05)], absolute lymphocyte count (ALC) [3.9±3.1 vs 1.23±1.7, respectively (p=0.04)], and stage IV HM disease in (100 vs. 45%, respectively).  The Charlson’s weighted comorbidity index was not different between the two groups [2.7±0.8 vs 2.2±0.5, respectively (p=0.2)].  A single chemotherapeutic agent could not be statistically identified as a risk factor for predisposing to CMVD.

    Conclusion: Older patients with stage IV lymphoproliferative diseases, specifically NHL and CLL, are at increased risk for CMVD irrespective of the chemotherapy used.  Vigilant surveillance of this population may help predict, and prevent CMVD.

    Mona Alfares, MD1, Susan Szpunar, PhD2, Mary Mandziara, MSN, ACNP-BC, AOCN3, Kleanthe Kolizeras, BS3, Ayad al-Katib, M.D.4 and Karam Obeid, MD4, (1)St John Hospital & Medical Center, Detroit, MI, (2)Graduate Medical Education, St. John Hospital and Medical Center, Grosse Pointe Woods, MI, (3)Hematology Oncology, St. John Hospital and Medical Center, Grosse Pointe Woods, MI, (4)Medicine, St. John Hospital and Medical Center, Grosse Pointe Woods, MI

    Disclosures:

    M. Alfares, None

    S. Szpunar, None

    M. Mandziara, None

    K. Kolizeras, None

    A. al-Katib, None

    K. Obeid, None

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