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Cytomegalovirus infection does not impact on survival or time to first treatment in patients with chronic lymphocytic leukemia

Parry, Helen Marie; Damery, Sarah; Hudson, Christopher; Maurer, Matthew J.; Cerhan, James R.; Pachnio, Annette; Begum, Jusnara; Slager, Susan L.; Fegan, Christopher; Man, Stephen; Pepper, Christopher; Shanafelt, Tait D.; Pratt, Guy; Moss, Paul A.H.

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Authors

Helen Marie Parry

Sarah Damery

CHRISTOPHER HUDSON chris.hudson@nottingham.ac.uk
Professor of Dairy Herd Health and Production

Matthew J. Maurer

James R. Cerhan

Annette Pachnio

Jusnara Begum

Susan L. Slager

Christopher Fegan

Stephen Man

Christopher Pepper

Tait D. Shanafelt

Guy Pratt

Paul A.H. Moss



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.

Citation

Parry, H. M., Damery, S., Hudson, C., Maurer, M. J., Cerhan, J. R., Pachnio, A., …Moss, P. A. (2016). Cytomegalovirus infection does not impact on survival or time to first treatment in patients with chronic lymphocytic leukemia. American Journal of Hematology, 91(8), https://doi.org/10.1002/ajh.24403

Journal Article Type Article
Acceptance Date Apr 25, 2016
Online Publication Date Apr 28, 2016
Publication Date Aug 1, 2016
Deposit Date Oct 27, 2016
Publicly Available Date Oct 27, 2016
Journal American Journal of Hematology
Print ISSN 0361-8609
Electronic ISSN 1096-8652
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 91
Issue 8
DOI https://doi.org/10.1002/ajh.24403
Public URL https://nottingham-repository.worktribe.com/output/975588
Publisher URL http://onlinelibrary.wiley.com/doi/10.1002/ajh.24403/full
Contract Date Oct 27, 2016

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