Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes

Viral enteritis is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, data regarding the most frequent enteric pathogens, clinical characteristics, and patient outcomes remains limited. To better characterize post-HSCT viral enteritis, we retrospecti...

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Main Authors: Hai-Lu Sun, Xiang-Yu Zhao, Xiao-Dong Mo, Meng Lv, Yu-Qian Sun, Fang-Fang Wei, Lan-Ping Xu, Yu Wang, Xiao-Hui Zhang, Xiao-Jun Huang, Xiao-Su Zhao, Xu-Ying Pei
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Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1638865/full
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author Hai-Lu Sun
Xiang-Yu Zhao
Xiao-Dong Mo
Meng Lv
Yu-Qian Sun
Fang-Fang Wei
Lan-Ping Xu
Yu Wang
Xiao-Hui Zhang
Xiao-Jun Huang
Xiao-Jun Huang
Xiao-Jun Huang
Xiao-Su Zhao
Xu-Ying Pei
author_facet Hai-Lu Sun
Xiang-Yu Zhao
Xiao-Dong Mo
Meng Lv
Yu-Qian Sun
Fang-Fang Wei
Lan-Ping Xu
Yu Wang
Xiao-Hui Zhang
Xiao-Jun Huang
Xiao-Jun Huang
Xiao-Jun Huang
Xiao-Su Zhao
Xu-Ying Pei
author_sort Hai-Lu Sun
collection DOAJ
description Viral enteritis is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, data regarding the most frequent enteric pathogens, clinical characteristics, and patient outcomes remains limited. To better characterize post-HSCT viral enteritis, we retrospectively analyzed 59 patients who underwent allo-HSCT and were diagnosised with viral enteritis based on intestinal biopsy specimens. The most frequently identified pathogens were cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV), accounting for 37.3%, 37.3%, and 33.9% of cases, respectively. The median time for diagnosis was 56 days post-allo-HSCT. Diarrhea and abdominal pain were the predominant symptoms. Notably, 35 patients experienced diarrhea lasting 14 days or more, with a median duration of 16 days (range: 3–57 days). Forty-five patients were diagnosed with concurrent graft-versus-host disease (GVHD) by endoscopic examination. The overall survival rates for patients with viral enteritis at 1 and 3 years were 68.7% and 58.1%, respectively. Importantly, patients with CMV enteritis had significantly poorer overall survival compared to those with other viral enteritis types (P = 0.035). In conclusion, viral enteritis is a significant complication following allo-HSCT, with CMV, HHV-6, and EBV being the most common pathogens. Early identification and management are crucial, especially for CMV enteritis which is associated with poorer outcomes.
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spelling doaj-art-7c53a73b92884152a15d7c7f08fb12fb2025-08-20T03:40:54ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.16388651638865Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomesHai-Lu Sun0Xiang-Yu Zhao1Xiao-Dong Mo2Meng Lv3Yu-Qian Sun4Fang-Fang Wei5Lan-Ping Xu6Yu Wang7Xiao-Hui Zhang8Xiao-Jun Huang9Xiao-Jun Huang10Xiao-Jun Huang11Xiao-Su Zhao12Xu-Ying Pei13Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaPeking-Tsinghua Center for Life Sciences, Beijing, ChinaState Key Laboratory of Natural and Biomimetic Drugs, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaBeijing Key Laboratory of Hematopoietic Stem Cell Transplantation, National Clinical Research Center for Hematologic Disease, Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, ChinaViral enteritis is a common complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, data regarding the most frequent enteric pathogens, clinical characteristics, and patient outcomes remains limited. To better characterize post-HSCT viral enteritis, we retrospectively analyzed 59 patients who underwent allo-HSCT and were diagnosised with viral enteritis based on intestinal biopsy specimens. The most frequently identified pathogens were cytomegalovirus (CMV), human herpesvirus 6 (HHV-6), and Epstein-Barr virus (EBV), accounting for 37.3%, 37.3%, and 33.9% of cases, respectively. The median time for diagnosis was 56 days post-allo-HSCT. Diarrhea and abdominal pain were the predominant symptoms. Notably, 35 patients experienced diarrhea lasting 14 days or more, with a median duration of 16 days (range: 3–57 days). Forty-five patients were diagnosed with concurrent graft-versus-host disease (GVHD) by endoscopic examination. The overall survival rates for patients with viral enteritis at 1 and 3 years were 68.7% and 58.1%, respectively. Importantly, patients with CMV enteritis had significantly poorer overall survival compared to those with other viral enteritis types (P = 0.035). In conclusion, viral enteritis is a significant complication following allo-HSCT, with CMV, HHV-6, and EBV being the most common pathogens. Early identification and management are crucial, especially for CMV enteritis which is associated with poorer outcomes.https://www.frontiersin.org/articles/10.3389/fmed.2025.1638865/fullviral enteritisallogeneic hematopoietic stem cell transplantationcytomegalovirusEpstein-Barr virushuman herpesvirus 6
spellingShingle Hai-Lu Sun
Xiang-Yu Zhao
Xiao-Dong Mo
Meng Lv
Yu-Qian Sun
Fang-Fang Wei
Lan-Ping Xu
Yu Wang
Xiao-Hui Zhang
Xiao-Jun Huang
Xiao-Jun Huang
Xiao-Jun Huang
Xiao-Su Zhao
Xu-Ying Pei
Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes
Frontiers in Medicine
viral enteritis
allogeneic hematopoietic stem cell transplantation
cytomegalovirus
Epstein-Barr virus
human herpesvirus 6
title Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes
title_full Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes
title_fullStr Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes
title_full_unstemmed Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes
title_short Viral enteritis after allogeneic hematopoietic stem cell transplantation: pathogens, clinical characteristics, and outcomes
title_sort viral enteritis after allogeneic hematopoietic stem cell transplantation pathogens clinical characteristics and outcomes
topic viral enteritis
allogeneic hematopoietic stem cell transplantation
cytomegalovirus
Epstein-Barr virus
human herpesvirus 6
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1638865/full
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