Prevalence of high-risk human papillomavirus infection in allogeneic stem cell transplant recipients.

Abstract

e18565 Background: Persistent infection with high-risk human papillomavirus (HR-HPV) is an important cause of malignancy, and patients receiving allogeneic hematopoietic stem cell transplant (SCT) for hematologic malignancies are at heightened risk of HPV-related secondary malignancies due to immunosuppressive therapies and graft versus host disease. However, the prevalence of HR-HPV among SCT recipients has not been well established. We aimed to describe the prevalence of HR-HPV in this population. Methods: This prospective observational study enrolled patients at MD Anderson Cancer Center planning to undergo allogeneic SCT for hematologic malignancies from March 2017 to January 2019. Patients completed a self-administered survey providing demographic information and HPV-related risk factors. Specimens were collected at 3 anatomical sites (oral, anal, and either cervical [female] or penile [male]) before and at 6-12 months after SCT. Cervical specimens were tested with Cervista. Oral, anal, and penile specimens underwent HPV PCR-based testing. Specimens that had a positive HPV result were then genotyped using the Roche Linear Array HPV test, which detects 37 HPV types including 14 HR-HPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68). Results: A total of 48 eligible patients were identified, and of these, 40 (27 males, 13 females) were enrolled in the study. Median age at enrollment was 54 years (range 22-69). All 40 patients received baseline HPV testing, and 12 patients received 6-12-month follow-up testing. At baseline 9 patients had positive HR-HPV test results (22.5%, 95% CI 10.8-38.5%). In females, prevalence of HR-HPV was highest in the cervical (2/13, 15%) and anal (2/13, 15%) specimens; none tested positive for HR-HPV in oral specimens. In males, prevalence of HR-HPV was highest in the penile (4/27, 15%) and oral (3/27, 11%) specimens; none tested positive for HR-HPV in anal specimens. Of the 12 patients who had baseline and follow up testing, 2 tested positive for HR-HPV before SCT. Among these, 1 patient's testing remained positive for HR-HPV after SCT. Conclusions: The prevalence of HR-HPV infection was high in our population of SCT recipients. In females, HR-HPV positivity was most frequently seen in cervical and anal specimens, while in males HR-HPV positivity was most frequently seen in penile and oral specimens. Larger studies with longer follow up are warranted to evaluate the long-term effects of HR-HPV positivity on development of HPV-related secondary malignancies in this population.