A1 Refereed original research article in a scientific journal
Clinical characteristic and outcome of HHV-6 encephalitis after allogeneic hematopoietic cell transplantation: A study of Infectious Disease Working Party of EBMT
Authors: Perruccio, Katia; Ward, Katherine N.; Tridello, Gloria; Knelange, Nina; Zeiser, Robert; Franke, Georg-Nikolaus; Sirvent, Anne; Einsele, Hermann; Vicent, Marta Gonzalez; Navarro, Jose Maria Fernandez; Contentin, Nathalie; Collin, Matthew; Martino, Rodrigo; Gambella, Massimiliano; Sengeloev, Henrik; Passweg, Jakob; Snowden, John; Nagler, Arnon; Kulagin, Alexander; Gabriel, Melissa; Kroeger, Nicolaus; Cascon, Maria Jesus Pascual; Yeshurun, Moshe; Gungor, Tayfun; Robin, Christine; Clark, Andrew; Duarte, Monica Lopez; Amor, Adrian Alegre; Itälä-Remes, Maija; Mikulska, Malgorzata; Styczynski, Jan; de la Camara, Rafael; Ljungman, Per; Averbuch, Dina; Cesaro, Simone
Publisher: Springer Nature
Publishing place: LONDON
Publication year: 2025
Journal: Bone Marrow Transplantation
Journal name in source: BONE MARROW TRANSPLANTATION
Journal acronym: BONE MARROW TRANSPL
Number of pages: 6
ISSN: 0268-3369
eISSN: 1476-5365
DOI: https://doi.org/10.1038/s41409-025-02638-7
Web address : https://www.nature.com/articles/s41409-025-02638-7
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.
