[Clinical Characteristics and Risk Factors of Human Cytomegalovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation in Children with Acute Myeloid Leukemia].

[OBJECTIVE] To investigate the clinical characteristics and risk factors of human cytomegalovirus infection (HCMV) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with acute myeloid leukemia (AML).

[METHODS] Clinical data and laboratory examinations of 50 children with AML who underwent allo-HSCT at Children's Hospital Affiliated of Zhengzhou University from June 1, 2020 to July 1, 2023 were retrospectively analyzed. Based on the occurrence of HCMV infection within 100 days after allo-HSCT, the children were categorized into HCMV-positive and HCMV-negative groups. Comparative analysis of clinical data between the two groups was performed, the logistic regression was utilized to identify risk factors for HCMV infection during this period. Survival analysis was further conducted for both cohorts.

[RESULTS] In this 50 children, HCMV infection occurred in 20 children within 100 days after transplantation, with a cumulative incidence of 40%, and the median time to the first HCMV infection was 45.5(35-60) days after transplantation. Univariate analysis showed that the post-transplantation recurrence, post-transplantation EBV infection, pretreatment application of anti-human thymocyte globulin (ATG) and matched sibling transplantation might influence the HCMV infection in children within 100 days after allo-HSCT (all < 0.01). Multivariate analysis showed that post-transplantation recurrence and post-transplantation EBV infection were independent risk factors for HCMV infection within 100 days after allo-HSCT (all < 0.05), while matched sibling transplantation was a protective factor against HCMV infection during this period ( < 0.05). Survival analysis showed that the difference in the EFS rate of AML relapse at 1 year post-transplantation between the HCMV-positive group and HCMV-negative group was statistically significant ( < 0.01), while the difference in the EFS rate of aGVHD between the two groups was not statistically significant ( >0.05).

[CONCLUSION] Relapse and EBV infection are independent risk factors for HCMV infection within 100 days post-allo-HSCT in AML children, while matched sibling transplantation serves as a protective factor.