ArticleFrontiers in cellular and infection microbiology2026
Late-phase impact of CMV/EBV reactivation on survival after hematopoietic stem-cell transplantation: a 5-year single-center cohort study.
Article in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Whether simultaneous cytomegalovirus (CMV) and Epstein-Barr virus (EBV) reactivation confers additional late mortality beyond isolated CMV remains controversial. Methods: We retrospectively analyzed 202 consecutive first-ever hematopoietic stem cell transplantations performed between 2018 and 2019, using twice-weekly PCR surveillance and uniform preemptive therapy. Cox models were used to estimate hazard ratios (HRs) for overall survival (OS) and leukemia-free survival (LFS) at the 1-, 3-, and 5-year landmarks. Results: Although 1-year outcomes were similar, divergence emerged thereafter: 5-year OS was 19.4% with coreactivation, 36.6% with isolated CMV, and 25.1% with no reactivation ( Conclusions: Late mortality is driven by persistent CMV-driven endothelial injury rather than transient EBV coreactivation. Extending PCR surveillance from day 100 to year 2 and targeting chronic low-level CMV should be prioritized to improve long-term transplantation success.
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