ArticleBone marrow transplantation2026
Impact of antiviral therapies on survival in patients with HHV-6B encephalitis after cord blood transplantation: a real-world study.
Article in Bone marrow transplantation, 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
In this registry-based study, we evaluated the efficacy of different antiviral therapies for adult patients who developed human herpesvirus-6B (HHV-6B) encephalitis after their first cord blood transplantation (CBT). Among 3,862 CBT recipients registered in Japan between January 2019 and December 2023, HHV-6B encephalitis occurred in 289 patients within 100 days post-transplant (7.5%). Antiviral treatments included foscarnet (FCN) monotherapy (n = 190), ganciclovir (GCV) monotherapy (n = 12), and FCN/GCV combination therapy (n = 74). The FCN/GCV group was associated with a potential improvement in 1-year survival compared with the FCN and GCV groups (63.2% vs. 52.5% vs. 41.7%, p = 0.38). Moreover, FCN/GCV therapy was identified as an independent predictor of improved survival compared with FCN monotherapy (HR, 0.60; 95% CI, 0.38-0.95; p = 0.031). Furthermore, the combination FCN/GCV therapy showed better survival than FCN monotherapy in the patients after neutrophil engraftment (1-year survival 68.1% vs. 51.6%), but worse survival in patients before engraftment (1-year survival 34.1% vs. 54.6%). Together, these findings provide real-world evidence linking antiviral regimen selection to post-transplant outcomes in HHV-6B encephalitis and suggest that FCN/GCV combination therapy may offer a survival advantage over FCN monotherapy in selected CBT patients, with treatment strategies potentially tailored according to hematologic recovery.
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