JCHOR
Journal of Current Hematology & Oncology Research

The Journal of Current Hematology & Oncology Research regularly publishes internationally qualified research in hematology and oncology within the current scholarly knowledge.

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Original Article
CMV reactivation after autologous stem cell transplantation: exploratory associations with transfusion burden and pre-transplant IMID exposure
Abstract
Aims: To evaluate the incidence of CMV reactivation and disease after autologous stem cell transplantation (ASCT), identify risk factors with particular focus on erythrocyte transfusion burden and immunomodulatory drug (IMID) exposure, and determine high-risk subgroups warranting intensified surveillance.
Methods: Retrospective analysis of 188 CMV-seropositive ASCT recipients at Erciyes University between 2007–2016. CMV PCR was performed twice weekly for the first 100 days. Erythrocyte suspension (ES) and platelet suspension (PS) were analysed separately alongside combined transfusion burden. Fisher exact and chi-square tests were used (SPSS v16.0).
Results: CMV reactivation occurred in 44 patients (23.4%); 40 (90.9%) had asymptomatic DNAemia and 4 (9.1%) developed CMV disease. All reactivation events occurred within day +46. Refractory/progressive disease was associated with higher reactivation rates (50.0% vs 21.9%; p=0.056). ES ?6 units was strongly associated with CMV reactivation (62.5% vs 24.0%; odds ratio [OR] 5.28, 95% confidence interval [CI]: 1.20–23.18; p=0.028), while PS alone was not (p=0.429). IMID exposure was significantly protective in multiple myeloma (MM) patients (9.5% vs 27.4%; p=0.022) and the overall cohort (9.3% vs 27.6%; p=0.013). The protective effect was independent of IMID timing (pre-transplant 10.5% vs post-transplant 9.5%; p=1.000). Conditioning regimen was not associated with CMV reactivation (p=0.863).
Conclusion: Refractory disease and high erythrocyte transfusion burden are the strongest predictors of CMV reactivation after ASCT. ES is the primary transfusion-related determinant. The timing-independent protective effect of IMIDs suggests a durable NK-cell mediated immunological mechanism. Risk-stratified CMV monitoring is recommended for high-risk subgroups.

Keywords : Autologous stem cell transplantation, cytomegalovirus, immunomodulatory drugs, erythrocyte transfusion, NK-cell activation

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Ethical Statement

<p>This study was approved by the Clinical Researches Ethics Committee of Erciyes University (Date: 15.09.2017, Decision No: 2017/430).</p>

Informed Consent

<p>This retrospective study used pre-existing anonymized patient data. No additional intervention was performed, and there was no direct patient contact. The study was approved by the Ethics Committee, and the requirement for written informed consent was waived by the ethics committee.</p>

Author Contributions

<p>Concept: MI, LK; Design: MI, LK, SG; Control: MI, LK, SG, M&Ccedil;; Resources: MI, LK; Materials: MI, LK, SG; Data Collection and/or Processing: MI, LK, SG, M&Ccedil;; Analysis and/ or Interpretation: MI, LK; Literature Review: MI, LK, SG; Writing the Article: MI, LK; Critical Review: MI, LK, SG, M&Ccedil;.</p>

Conflict of Interest

<p>The authors declare no conflicts of interest related to this study.</p>

Financial Disclosure

<p>The authors received no financial support for the conduct or publication of this research.</p>


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Article available in :
Volume 4, Issue 4, 2026
Page : 135-139
https://doi.org/10.51271/JCHOR-0097
Article Information
Received : 08 Jun 2026
Accepted : 17 Aug 2026
Published : 13 Nov 2026
Corresponding Author :

Meral Ilgaz: Department of Hematology, Kırıkkale Yüksek İhtisas Hospital, Kırıkkale, Turkiye

[email protected]
Citation : Ilgaz M, Gökahmetoğlu S, Çelik M, Kaynar L. CMV reactivation after autologous stem cell transplantation: exploratory associations with transfusion burden and pre-transplant IMiD exposure. J Curr Hematol Oncol Res. 2026;4(4):135-139. doi:10.51271/JCHOR-0097

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