迟发性巨细胞病毒（CMV）疾病被定义为移植后100天之后发生的CMV疾病，仍然是同种异体干细胞移植受者中的一个重要并发症，尽管预防性使用甘昔洛韦先发治疗的策略已经成立。由于近年来供体来源和条件准备方案的扩大，因此有必要重新评估迟发性CMV疾病的发生率、危险因素和临床影响。本研究纳入了从2008年至2015年间进行首次移植的1295名成年患者，排除了移植后100天内有基础疾病复发或CMV疾病的情况。在中位随访时间长达48.4个月的期间，有21名患者发生了迟发性CMV疾病，5年累积发病率为1.6%。多变量分析显示，半相合相关供体、成年人T细胞白血病淋巴瘤和移植后100天之前的先发治疗被提取为独立危险因素。迟发性CMV疾病对移植结果产生负面影响，并被确定为非复发死亡率（风险比3.83，p < 0.001）和总生存率（风险比4.01，p < 0.001）的独立危险因素。虽然21名迟发性CMV疾病患者中有17名死亡，但与CMV相关的死亡主要与3名患有CMV肺炎的患者相关。尽管移植受者迟发性CMV病例的发生率较低，但这种并发症对临床过程产生负面影响。因此，具有这些危险因素的移植受者应该更加谨慎管理。 © 2023 日本化学疗法学会，日本传染病协会和日本感染预防与控制学会。由Elsevier Ltd.发表。版权所有。

Late cytomegalovirus (CMV) disease, which was defined as CMV disease occurring >100 days post-transplant, remains an important complication among allogeneic stem cell transplant recipients, even now that the prophylactic strategy using ganciclovir preemptive therapy has been established. Due to the recent expansion of donor sources and conditioning regimens, it is therefore appropriate to reevaluate the incidence, risk factors, and clinical impacts of late CMV disease.This study included the 1295 adult patients, who underwent transplant for the first time from 2008 to 2015, without underlying disease relapse or CMV disease within 100 days post-transplant. There were no restrictions on underlying diseases or transplant procedures.During the median follow-up period of 48.4 months, 21 patients developed late CMV disease and the 5-year cumulative incidence of late CMV disease was 1.6%. By multivariate analysis, haploidentical related donor, adult T-cell leukemia lymphoma, and preemptive therapy before 100 days post-transplant were extracted as independent risk factors. Late CMV disease negatively affected transplant outcomes, and was identified as an independent risk factor for the non-relapse mortality rate (hazard ratio 3.83, p < 0.001) and overall survival rate (hazard ratio 4.01, p < 0.001). Although 17 of 21 patients with late CMV disease died, the main causes of death were not related to CMV, except in three patients with CMV pneumonia.Although the incidence of late CMV disease is low in transplant recipients, this complication negatively affects clinical courses. Therefore, transplant recipients with these risk factors should be more carefully managed.Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.