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. 2022 Dec;50(6):1543-1555.
doi: 10.1007/s15010-022-01847-2. Epub 2022 May 28.

Cytomegalovirus infection and rehospitalization rates after allogeneic hematopoietic stem cell and solid organ transplantation: a retrospective cohort study using German claims data

Daniel Teschner  1   2 , Jana Knop  3 , Christian Piehl  3 , Sophia Junker  4 , Oliver Witzke  5   6
Affiliations

Cytomegalovirus infection and rehospitalization rates after allogeneic hematopoietic stem cell and solid organ transplantation: a retrospective cohort study using German claims data

Daniel Teschner et al. Infection. 2022 Dec.

Abstract

Purpose: This study aimed to describe the cytomegalovirus (CMV) infection rate, rehospitalizations, and comorbidities following allogeneic hematopoietic stem cell transplantation (allo-HSCT) and solid organ transplantation (SOT).

Methods: Patients who received allo-HSCT or SOT in 01/07/2015-30/06/2018 were identified using anonymized German claims data. The transplantation-related hospital admission date was defined as the index date, and patients were followed for up to 12 months (or death, first event relevant). The frequency of CMV infections (confirmed outpatient/inpatient diagnoses, ICD-10-GM codes: B25.-/B27.1) and the rate, number, and duration of all-cause rehospitalizations in the follow-up period were evaluated.

Results: A total of 226 allo-HSCT and 250 SOT patients were identified (mean age 52.8 years, 38.9% female). During the 12 months after transplantation, 29.2% of allo-HSCT patients and 16.8% of SOT patients received a CMV diagnosis. The majority of these diagnoses were given during the initial hospitalization or within the following 3 months. Across transplantation types, CMV patients had more hospital readmission days per patient-year (allo-HSCT 93.3 vs. 49.4, p = 0.001; SOT 42.0 vs. 20.7, p = 0.005), with a longer mean duration of readmissions (allo-HSCT 22.4 vs. 15.4 days, p < 0.001; SOT 11.6 vs. 7.5 days, p = 0.003). Comorbidity burden in transplantation patients was substantial, with several diagnoses being significantly more common among patients with CMV vs. non-CMV. One-year mortality did not differ significantly between patients with/without CMV.

Conclusion: Burden of transplant recipients with CMV in terms of rehospitalizations and comorbidities is substantial, highlighting the need for improved CMV prevention and treatment.

Keywords: Allogeneic hematopoietic stem cell transplantation; Claims data; Cytomegalovirus; Solid organ transplantation.

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Conflict of interest statement

DT received honoraria and travel grants from ACI Clinical, BioNTech, Gilead, F2G, iQone, MSD, Octapharma, Pfizer, and Takeda, received travel grants from AbbVie, Astellas, Celgene, Jazz, and Medac, serves as a consultant for ACI Clinical, BioNTech, Gilead, iQone, MSD, Octapharma, Pfizer, and Takeda, and received research grants from Gilead. JK is an employee of Takeda Pharma Vertrieb GmbH & Co. KG. CP is an employee of Takeda Pharma Vertrieb GmbH & Co. KG and owner of Takeda shares. SJ is an employee of Ingress-Health HWM GmbH, a wholly owned subsidiary of Cytel Inc., contracted by Takeda Pharma Vertrieb GmbH & Co. KG to conduct this research. OW received research grants for clinical studies, speaker’s fees, honoraria, and travel expenses from Alexion, Amgen, Astellas, Basilea, Biotest, Bristol Myers Squibb, Chiesi, Correvio, Gilead, Hexal, Janssen, Dr. F. Köhler Chemie, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi, Takeda, Teva, and UCB, as well as an Unrestricted grant of the Rudolf-Ackermann-Stiftung (Stiftung für Klinische Infektiologie).

Figures

Fig. 1
Fig. 1
Kaplan–Meier failure curve of the estimated probability of receiving a CMV diagnosis after initial hospital admission for transplantation for allo-HSCT and SOT patients. Abbreviations: Allo-HSCT allogeneic hematopoietic stem cell transplantation, CI confidence interval, CMV cytomegalovirus, SOT solid organ transplantation
See this image and copyright information in PMC

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