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-Julián, A, Ríos-Barnés, M, Fortuny, C, Villaverde, S, Frick, MA, Vallejo, BA, Soler-Palacín, P, Saavedra, J, Karagiannidou, S, Rincón, E, 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, Blázquez-Gamero, D
Publicada:
1 nov 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:
Natl & Kapodistrian Univ Athens, Univ Gen Hosp ATTIKON, Dept Pediat 3, Athens, Greece
Pedrero-Tomé, R:
Inst Invest Hosp 12 Octubre imas12, Pediat Res & Clin Trials Unit UP, Madrid, Spain
Syridou, G:
Natl & Kapodistrian Univ Athens, Univ Gen Hosp ATTIKON, Dept Pediat 3, Athens, Greece
Baquero-Artigao, F:
Hosp Univ La Paz, Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Madrid, Spain
Rodríguez-Molino, P:
Hosp Univ La Paz, Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Madrid, Spain
del Rosal, T:
Hosp Univ La Paz, Ctr Invest Biomed Red Enfermedades Infecciosas CIB, Madrid, Spain
Noguera-Julián, A:
Inst Recerca St Joande Deu, Pediat Infect Dis Dept, Infect Dis & Syst Inflammatory Response Pediat, Barcelona, Spain
Ctr Biomed Network Res Epidemiol & Publ Hlth CIBER, Madrid, Spain
Univ Barcelona, Dept Cirurgia & Especialitats Medicoquirurg, Fac Med & Ciencies Salut, Barcelona, Spain
Ríos-Barnés, M:
Inst Recerca St Joande Deu, Pediat Infect Dis Dept, Infect Dis & Syst Inflammatory Response Pediat, Barcelona, Spain
Fortuny, C:
Inst Recerca St Joande Deu, Pediat Infect Dis Dept, Infect Dis & Syst Inflammatory Response Pediat, Barcelona, Spain
Ctr Biomed Network Res Epidemiol & Publ Hlth CIBER, Madrid, Spain
Univ Barcelona, Dept Cirurgia & Especialitats Medicoquirurg, Fac Med & Ciencies Salut, Barcelona, Spain
Villaverde, S:
Inst Invest Hosp 12 Octubre imas12, Pediat Res & Clin Trials Unit UP, Madrid, Spain
Frick, MA:
Univ Barcelona, Dept Cirurgia & Especialitats Medicoquirurg, Fac Med & Ciencies Salut, Barcelona, Spain
Vallejo, BA:
Hosp Infantil Vall dHebron, Unidad Patol Infecciosa & Immunodeficiencias Pedia, Barcelona Hosp Campus, Barcelona, Catalunya, Spain
Vall dHebron Res Inst, Barcelona, Spain
Soc Espanola Infectol Pediat SEIP, Grp Trabajo Infecc Congenitas, Murcia, Spain
Soler-Palacín, P:
Hosp Infantil Vall dHebron, Unidad Patol Infecciosa & Immunodeficiencias Pedia, Barcelona Hosp Campus, Barcelona, Catalunya, Spain
Vall dHebron Res Inst, Barcelona, Spain
Soc Espanola Infectol Pediat SEIP, Grp Trabajo Infecc Congenitas, Murcia, Spain
Saavedra, J:
Hosp Univ Gregorio Maranon, Pediat Infect Dis Unit, Madrid, Spain
Univ Complutense Madrid, Inst Invest Sanitaria Gregorio Maranon IiSGM, Madrid, Spain
Ctr Biomed Network Res Infect Dis CIBERINFEC, Madrid, Spain
Karagiannidou, S:
Natl & Kapodistrian Univ Athens, Univ Gen Hosp ATTIKON, Dept Pediat 3, Athens, Greece
Rincón, E:
Hosp Univ Gregorio Maranon, Pediat Infect Dis Unit, Madrid, Spain
Univ Complutense Madrid, Inst Invest Sanitaria Gregorio Maranon IiSGM, Madrid, Spain
Ctr Biomed Network Res Infect Dis CIBERINFEC, Madrid, Spain
Busselo, IS:
Hosp Donostia, Dept Pediat, Donostia San Sebastian, Spain
Zuriarrain, OM:
Hosp Donostia, Dept Pediat, Donostia San Sebastian, Spain
Calderón, EM:
Hosp Santa Creu & Sant Pau, Dept Pediat, Barcelona, Spain
Tagarro, A:
Hosp Univ Infanta Sofia, Dept Pediat, San Sebastian De Los Reye, Spain
Malumbres, M:
Complejo Hosp Navarra, Dept Pediat, Navarra, Spain
Colino, E:
Complejo Hosp Univ Insular Materno Infantil Las Pa, Dept Pediat, Las Palmas Gran Canaria, Spain
Llanos, EG:
Basurto Univ Hosp, Dept Pediat, Bilbao, Spain
Ruiz, AM:
Virgen Arrixaca Univ, Clin Hosp, Dept Pediat, Murcia, Spain
Mateos, MS:
Puerta Hierro Majadahonda Univ Hosp, Dept Pediat, Madrid, Spain
Espuny, XB:
Hosp Arnau Vilanova, Dept Pediat, Lleida, Spain
Alonso-Ojembarrena, A:
Puerta Del Mar Univ Hosp, Neonatal Intens Care Unit, Cadiz, Spain
Puerta del Mar Univ Hosp, Biomed Res & Innovat Inst Cadiz INiB, Res Unit, Cadiz, Spain
Ferreras-Antolin, L:
Hosp Carlos Haya, Dept Pediat, Malaga, Spain
Pérez, IC:
Getafe Univ Hosp, Dept Pediat, Madrid, Spain
Posse, AF:
Son Llatzer Hosp, Dept Pediat, Palma De Mallorca, Illes Balears, Spain
Lyall, H:
Imperial Coll Healthcare NHS Trust, Pediat Infect Dis Unit, London, England
Blázquez-Gamero, D:
Inst Invest Hosp 12 Octubre imas12, Pediat Res & Clin Trials Unit UP, Madrid, Spain
Green Submitted
|