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Risk factors and clinical outcomes of cytomegalovirus diseases in hematologic malignancy patients without hematopoietic stem-cell transplantation

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Abstract

Purpose

This study aims to evaluate the risk factors and prognosis for CMV diseases in hematologic malignancy patients without hematopoietic stem-cell transplantation (HSCT).

Methods

We performed a case-control study (1:2) between 2012 and 2022. Adults with pathologic-confirmed CMV diseases (n=60) among hematologic malignancy patients were matched and compared to whom without CMV disease.

Results

Lymphoma was the most common underlying malignancy, and gastrointestinal tract involvement was the most common CMV disease. In the case group, high-dose steroid administration and transfusion within one month before diagnosis were higher (p<0.001). Steroid administration (aOR=5.78; 95% confidence interval: 1.25–26.68, p=0.024), red blood cell transfusion within one month (aOR=14.63; 2.75–77.76, p=0.002), low BMI (aOR=13.46, 2.07–87.45, p=0.006), and hypoalbuminemia (aOR=26.48, 5.93–118.17, p<0.001) were independent risk factors associated with CMV disease. The 30-day mortality was higher in the case group and CMV disease was significantly associated with all-cause mortality (aOR=14.41, 3.23–64.31, p<0.001).

Conclusion

In hematologic malignancy patients without HSCT, risk factors for CMV organ disease included high-dose steroid administration and RBC transfusion within one month, low BMI, and hypoalbuminemia. Overall mortality was significantly higher with CMV disease, and CMV disease occurrence was a significant risk factor for mortality.

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Data availability

The data included in this study are available upon reasonable request.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea

    Jinyoung Yang, Cheol-In Kang, Young Ho Lee, Jae-Hoon Ko, Kyungmin Huh, Sun Young Cho, Doo Ryeon Chung & Kyong Ran Peck

  2. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Chul Won Jung

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  1. Jinyoung Yang
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  2. Cheol-In Kang
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  5. Kyungmin Huh
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  6. Sun Young Cho
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  8. Kyong Ran Peck
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  9. Chul Won Jung
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Jinyoung Yang, Young Ho Lee, Jae-Hoon Ko, Kyungmin Huh, Sun Young Cho, Doo Ryeon Chung, Kyong Ran Peck, Chul Won Jung and Cheol-In Kang. The first draft of the manuscript was written by Jinyoung Yang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cheol-In Kang.

Ethics declarations

Ethical approval

The study was performed in line with the principles of the Declaration of Helsinki. This study was approved by the institutional review board of our institution (SMC 2022-06-099-001).

Consent to participate

Informed consent was waived due to the retrospective design of this study.

Competing interests

The authors declare no competing interests.

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Yang, J., Kang, CI., Lee, Y.H. et al. Risk factors and clinical outcomes of cytomegalovirus diseases in hematologic malignancy patients without hematopoietic stem-cell transplantation. Support Care Cancer 32, 56 (2024). https://doi.org/10.1007/s00520-023-08258-5

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