Immune dysfunction resulting from allogeneic haematopoietic stem cell transplantation
(aHSCT) predisposes one to an elevated risk of cytomegalovirus (CMV) infection. Changes in
metabolism have been associated with adverse outcomes, and in this study, we explored the asso-
ciations between metabolic profiles and post-transplantation CMV infection using plasma samples
collected 7–33 days after aHSCT. We included 68 aHSCT recipients from Rigshospitalet, Denmark,
50% of whom experienced CMV infection between days 34–100 post-transplantation. First, we inves-
tigated whether 12 metabolites selected based on the literature were associated with an increased risk
of post-transplantation CMV infection. Second, we conducted an exploratory network-based analysis
of the complete metabolic and lipidomic profiles in relation to clinical phenotypes and biological
pathways. Lower levels of trimethylamine N-oxide were associated with subsequent CMV infection
(multivariable logistic regression: OR = 0.63; 95% CI = [0.41; 0.87]; p = 0.01). Explorative analysis
revealed 12 clusters of metabolites or lipids, among which one was predictive of CMV infection, and
the others were associated with conditioning regimens, age upon aHSCT, CMV serostatus, and/or
sex. Our results provide evidence for an association between the metabolome and CMV infection
post-aHSCT that is independent of known risk factors.