Effects of human herpesvirus 6B reactivation on cognitive function in cord blood transplant recipients: a prospective multicenter study

• Published in: International journal of hematology Vol. 119; no. 4; pp. 432 - 441
• Main Authors: Ogata, Masao, Oshima, Kumi, Takano, Kuniko, Kawano, Rie, Ueda, Yasunori, Imamura, Takashi, Nakamura, Yukinori, Okada, Takahiro, Toubai, Tomomi, Ueki, Toshimitsu, Uoshima, Nobuhiko, Ishida, Hiroyuki, Shinohara, Akihito, Seo, Sachiko, Fukuda, Takahiro, Inagaki, Masatoshi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Nature Singapore 01.04.2024; Springer Nature B.V
• Subjects: Blood; Central nervous system; Cognition; Cognitive ability; Cord blood; Cord Blood Stem Cell Transplantation - adverse effects; Delirium; DNA, Viral; Hematology; Hematopoietic Stem Cell Transplantation; Herpes viruses; Herpesvirus 6, Human - genetics; Humans; Information processing; Medicine; Medicine & Public Health; Memory; Mental disorders; Oncology; Original; Original Article; Preconditioning; Prospective Studies; Quality of Life; Transplantation; Transplants & implants; Virus Activation; Human herpesvirus-6B; Cognitive function; Memory function; Cord blood transplantation
• DOI: 10.1007/s12185-024-03714-2
• ISSN: 0925-5710; 1865-3774

This prospective multicenter study aimed to determine the effects of human herpesvirus-6B (HHV-6B) reactivation on central nervous system (CNS) function in cord blood transplant (CBT) recipients. Our focus was to track HHV-6B reactivation and evaluate its association with delirium and cognitive function, specifically in the domains of verbal memory, attention/processing speed, and quality of life (QOL). A cohort of 38 patients participated in this study. Of the 37 patients evaluated, seven (18.9%) developed delirium, with six of these cases emerging after HHV-6B reactivation (median lag, 7 days). Evaluation of verbal memory showed that the final trial score for unrelated words at 70 days after transplantation was significantly lower than that before preconditioning ( P  = 0.004) among patients ( n  = 15) who experienced higher-level HHV-6B reactivation (median or higher maximum plasma HHV-6 DNA load for participating patients). Patients without higher-level reactivation did not show significant declines in verbal memory scores. QOL was assessed using the 36-item Short-Form Health Survey, and the social functioning score 1 year post-transplantation was significantly lower in patients who experienced higher-level HHV-6B reactivation than in those who did not. Our findings suggest that higher-level HHV-6B reactivation can detrimentally affect certain cognitive functions in CBT recipients.