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<p>Human herpes virus-6 (HHV-6) is the main cause of viral encephalitis in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). From January 2005 to December 2014, 97 patients with HHV-6 encephalitis were reported in the EBMT registry. The incidence was 0.45% after the first allo-HCT and varied with the type of donor and of stem cell source: sibling donor 0.06%, unrelated donor 0.68%, haploidentical donor 0.51%, cord blood 2.14%, bone marrow 0.20%, peripheral blood 0.44%. HHV-6 encephalitis occurred at a median time of 31 days from allo-HCT (range 16–317 days). With a median follow-up of 5.28 years, the 5-yr OS was 24.7%. The causes of death were: disease relapse/progression 11, infection 23, non-infectious cause 33, not specified 5. Forty-four deaths (61.1%) occurred within 90 days from diagnosis of HHV-6 encephalitis and in 24 HHV-6 encephalitis was considered a contributory cause. Eight-seven patients received treatment mainly with foscarnet or ganciclovir. In multivariate analysis, bone marrow/peripheral blood stem cell source and nonmyeloablative conditioning regimen were significant factors for lower survival. In conclusion, the incidence of HHV-6 encephalitis was low but associated with high mortality irrespective of antiviral treatment. This confirms the need for further research in this setting.</p>

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Clinical characteristic and outcome of HHV-6 encephalitis after allogeneic hematopoietic cell transplantation: A study of Infectious Disease Working Party of EBMT

  • 期刊论文

  • 发表日期：

    2025年6月3日

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  • Katia Perruccio,
  • Katherine N. Ward,
  • Gloria Tridello,
  • Nina Knelange,
  • Robert Zeiser,
  • Georg-Nikolaus Franke,
  • Anne Sirvent,
  • Hermann Einsele,
  • Marta Gonzalez Vicent,
  • Jose Maria Fernandez Navarro,
  • Nathalie Contentin,
  • Matthew Collin,
  • Rodrigo Martino,
  • Massimiliano Gambella,
  • Henrik Sengeloev,
  • Jakob Passweg,
  • John Snowden,
  • Arnon Nagler,
  • Alexander Kulagin,
  • Melissa Gabriel,
  • Nicolaus Kröger,
  • Maria Jesus Pascual Cascon,
  • Moshe Yeshurun,
  • Tayfun Güngör,
  • Christine Robin,
  • Andrew Clark,
  • Monica Lopez Duarte,
  • Adrian Alegre Amor,
  • Maija Itala-Remes,
  • Malgorzata Mikulska,
  • Jan Styczynski,
  • Rafael de la Camara,
  • Per Ljungman,
  • Dina Averbuch,
  • Simone Cesaro

摘要

Human herpes virus-6 (HHV-6) is the main cause of viral encephalitis in patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT). From January 2005 to December 2014, 97 patients with HHV-6 encephalitis were reported in the EBMT registry. The incidence was 0.45% after the first allo-HCT and varied with the type of donor and of stem cell source: sibling donor 0.06%, unrelated donor 0.68%, haploidentical donor 0.51%, cord blood 2.14%, bone marrow 0.20%, peripheral blood 0.44%. HHV-6 encephalitis occurred at a median time of 31 days from allo-HCT (range 16–317 days). With a median follow-up of 5.28 years, the 5-yr OS was 24.7%. The causes of death were: disease relapse/progression 11, infection 23, non-infectious cause 33, not specified 5. Forty-four deaths (61.1%) occurred within 90 days from diagnosis of HHV-6 encephalitis and in 24 HHV-6 encephalitis was considered a contributory cause. Eight-seven patients received treatment mainly with foscarnet or ganciclovir. In multivariate analysis, bone marrow/peripheral blood stem cell source and nonmyeloablative conditioning regimen were significant factors for lower survival. In conclusion, the incidence of HHV-6 encephalitis was low but associated with high mortality irrespective of antiviral treatment. This confirms the need for further research in this setting.