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Guidelines from the 2017 European Conference on Infections in Leukaemia for management of HHV-6 infection in patients with hematologic malignancies and after hematopoietic stem cell transplantation
Ferrata Storti Foundation
Haematologica 2019 Volume 104(11):2155-2163
Katherine N Ward,1 Joshua A Hill,2 Petr Hubacek,3 Rafael de la Camara,4 Roberto Crocchiolo,5 Hermann Einsele,6 David Navarro,7 Christine Robin,8 Catherine Cordonnier,8 and Per Ljungman;9 for the 2017 European Conference on Infections in Leukaemia (ECIL)*
1Division of Infection and Immunity, University College London, London, UK; 2Fred Hutchinson Cancer Research Center, Seattle, WA, USA; 3Department of Medical Microbiology and Department of Paediatric Haematology and Oncology 2nd Medical Faculty of Charles University and Motol University Hospital, Prague, Czech Republic; 4Department of Haematology, Hospital de la Princesa, Madrid, Spain; 5SIMT, ASST di Bergamo Ovest, Treviglio, Italy; 6Medizinische Klinik und Poliklinik II, Julius Maximilians Universität, Würzburg, Germany; 7Microbiology Service, Hospital Clínico Universitario, Instituto de Investigación INCLIVA and Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain; 8Department of Haematology, Henri Mondor Hospital, Assistance Publique-Hopitaux de Paris, Université Paris-Est Créteil, Créteil, France and 9Department of Cellular Therapy and Allogeneic Stem Cell Transplantation, Karolinska University Hospital, Division of Haematology, Department of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
*A joint project of the European Organization for Research and Treatment of Cancer - Infectious Diseases Group, European Society for Blood and Marrow Transplantation - Infectious Diseases Working Party, European Leukaemia Net-Project 15: Supportive Care and the International Immunocompromised Host Society
ABSTRACT
Of the two human herpesvirus 6 (HHV-6) species, human her- pesvirus 6B (HHV-6B) encephalitis is an important cause of mor- bidity and mortality after allogeneic hematopoietic stem cell trans- plant. Guidelines for the management of HHV-6 infections in patients with hematologic malignancies or post-transplant were prepared a decade ago but there have been no other guidelines since then despite significant advances in the understanding of HHV-6 encephalitis, its therapy, and other aspects of HHV-6 disease in this patient population. Revised guidelines pre- pared at the 2017 European Conference on Infections in Leukaemia cover- ing diagnosis, preventative strategies and management of HHV-6 disease are now presented.
Introduction
Over the past ten years, it has been recognized that human herpesvirus 6A (HHV-6A) and HHV-6B are distinct species,1 HHV-6B not HHV-6A is the most fre- quent cause of encephalitis post-hematopoietic stem cell transplant (HSCT) and that chromosomally integrated HHV-6 (CIHHV-6) is clinically significant. Revised European Conference on Infections in Leukemia (ECIL) HHV-6 guidelines were prepared after a literature review by a group of experts, and discussed at a plenary session on September 22nd, 2017 until consensus. Those guidelines specifically applying to treatment were graded according to pre-ordained criteria (Table 1) for level of evidence and strength of recommendation; participants were hematolo- gists, microbiologists and infectious disease specialists with expertise on infectious complications in hematology. (A list of ECIL meeting participants is provided in the Online Supplementary Appendix.) A final slide set was posted on the ECIL web- site (www.ecil-leukaemia.com) on October 2nd, 2017 and made available for open con- sultation.
Correspondence:
KATHERINE N WARD
k.n.ward@ucl.ac.uk
Received: April 1, 2019. Accepted: August 27, 2019. Pre-published: August 29, 2019.
doi:10.3324/haematol.2019.223073
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/104/11/2155
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