Severe Neutropenia in Infants With Congenital Cytomegalovirus on Antiviral Therapy.
Por:
Papaevangelou V, Pedrero-Tomé R, Syridou G, Baquero-Artigao F, Rodríguez-Molino P, Del Rosal T, Noguera-Julian A, Rios-Barnés M, Fortuny-Guasch C, Villaverde S, Frick MA, Vallejo BÁ, Soler-Palacín P, Saavedra J, Rincón E, Karagiannidou S, Busselo IS, Zuriarrain OM, Calderón EM, Tagarro A, Malumbres M, Colino E, Llanos EG, Ruiz AM, Mateos MS, Espuny XB, Alonso-Ojembarrena A, Ferreras-Antolin L, Pérez IC, Posse AF, Lyall H and Blázquez-Gamero D
Publicada:
1 nov 2025
Ahead of Print:
4 jul 2025
Resumen:
AIM: To describe European real-life experience of severe neutropenia (SN) during ganciclovir (GCV) and/or valganciclovir (VGCV) treatment in infants with congenital cytomegalovirus (cCMV) infection and identify risk factors associated with the development of SN. METHODS: A multicenter retrospective cohort study from the European cCMVnet registry included infants with confirmed cCMV infection treated since 2011 with GCV and/or VGCV. Details of treatment, including age at initiation, route of administration and duration, are described. Prevalence and risk factors associated with the development of SN, defined as neutrophil count of <500 cells/mm 3 , were analyzed. RESULTS: Overall, 566 children with confirmed cCMV treated with antivirals were included; 165 (29.7%) were born prematurely (gestational age <37 weeks). Administration of intravenous GCV, alone or in combination with oral VGCV, was associated with prematurity and date of birth before 2017. SN occurred in 102 infants (18%). Multivariate logistic regression analysis identified 2 independent risk factors for the development of SN: prematurity almost doubled the risk of developing SN [odds ratio (OR) = 1.961; 95% confidence interval (CI): 1.163-3.300], while the risk of developing SN increased by 11% for every 1000 neutrophils decrease in the absolute neutrophil count at baseline (OR = 1.104; 95% CI: 1.031-1.192). When term newborns were analyzed alone, baseline absolute neutrophil count remained an important risk factor for developing SN. CONCLUSIONS: In children with cCMV treated with GCV/VGCV prematurity and low pretreatment neutrophil counts are associated with an increased risk of developing SN. This is important for patient management, and when informing parents about treatment side effects.
Filiaciones:
Papaevangelou V:
From the Third Department of Pediatrics, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
Pedrero-Tomé R:
Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
Syridou G:
From the Third Department of Pediatrics, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
Baquero-Artigao F:
Hospital Universitario La Paz. Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)
Rodríguez-Molino P:
Hospital Universitario La Paz. Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)
Del Rosal T:
Hospital Universitario La Paz. Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC)
Noguera-Julian A:
Pediatric Infectious Diseases Department, Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
Rios-Barnés M:
Pediatric Infectious Diseases Department, Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
Fortuny-Guasch C:
Pediatric Infectious Diseases Department, Infectious Diseases and Systemic Inflammatory Response in Pediatrics, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
Centre for Biomedical Network Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain
Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
Villaverde S:
Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
Frick MA:
Departament de Cirurgia i Especialitats Medicoquirúrgiques, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
Vallejo BÁ:
Unidad de Patología Infecciosa e Immunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Barcelona Hospital Campus, Barcelona, Catalunya, España
Vall d'Hebron Research Institute, Barcelona, Spain
Grupo de Trabajo de Infecciones Congénitas, Sociedad Española de Infectología Pediátrica (SEIP), Spain
Soler-Palacín P:
Unidad de Patología Infecciosa e Immunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Barcelona Hospital Campus, Barcelona, Catalunya, España
Vall d'Hebron Research Institute, Barcelona, Spain
Grupo de Trabajo de Infecciones Congénitas, Sociedad Española de Infectología Pediátrica (SEIP), Spain
Saavedra J:
Pediatric Infectious Diseases Unit, Hospital Universitario Gregorio Marañón
Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid. Madrid, Spain
Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC)
Rincón E:
Pediatric Infectious Diseases Unit, Hospital Universitario Gregorio Marañón
Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid. Madrid, Spain
Center for Biomedical Network Research on Infectious Diseases (CIBERINFEC)
Karagiannidou S:
From the Third Department of Pediatrics, National and Kapodistrian University of Athens, University General Hospital ATTIKON, Athens, Greece
Busselo IS:
Department of Pediatrics. Hospital de Donostia, Donostia, Spain
Zuriarrain OM:
Department of Pediatrics. Hospital de Donostia, Donostia, Spain
Calderón EM:
Department of Pediatrics. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Tagarro A:
Department of Pediatrics, Hospital Universitario Infanta Sofia, San Sebastián de los Reyes, Spain
Malumbres M:
Department of Pediatrics, Complejo Hospitalario de Navarra, Navarra, Spain
Colino E:
Department of Pediatrics, Complejo Hospitalario Universitario Insular-Materno Infantil de Las Palmas de Gran Canaria
Llanos EG:
Department of Pediatrics, Basurto University Hospital, Bilbao, Spain
Ruiz AM:
Department of Pediatrics, Virgen of Arrixaca University Clinical Hospital, Murcia, Spain
Mateos MS:
Department of Pediatrics, Puerta de Hierro Majadahonda University Hospital, Madrid, Spain
Espuny XB:
Department of Pediatrics, Hospital Universitari Arnau de Vilanova, Lleida, Spain
Alonso-Ojembarrena A:
Neonatal Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain
Biomedical Research and Innovation Institute of Cádiz (INiBICA). Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
Ferreras-Antolin L:
Department of Pediatrics, Hospital Carlos Haya, Malaga, Spain
Pérez IC:
Department of Pediatrics, Getafe University Hospital, Madrid, Spain
Posse AF:
Department of Pediatrics, Son Llàtzer Hospital, Palma, Illes Balears, Spain
Lyall H:
Pediatric Infectious Diseases Unit, Imperial College Healthcare NHS Trust, London, UK
Blázquez-Gamero D:
Pediatric Research and Clinical Trials Unit (UPIC), Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
Green Submitted
|