Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Events

Assessment of CD4 T-lymphocyte reactivity by the Cylex ImmuKnow assay in patients following allogeneic hematopoietic SCT

Bone Marrow Transplantation volume 45, pages 527–533 (2010)Cite this article

Abstract

After allogeneic hematopoietic SCT (alloHSCT), immunosuppressed patients are susceptible to opportunistic infections, and uncontrolled function of the graft can result in GVHD. Accurate immune monitoring may help early detection and treatment of these severe complications. Between October 2005 and November 2007, a total of 170 blood samples were collected from 40 patients after alloHSCT in the Hadassah Hebrew University Medical Center and from 13 healthy controls. We utilized the Cylex ImmuKnow assay for CD4 ATP levels to compare known clinically immunocompromised vs immunocompetent patients after alloHSCT. We also compared the reconstitution of WBC count to the ImmuKnow results and clinical status. The patients’ clinical course correlated with the stratification of immune response established by the ImmuKnow assay for solid organ transplantation (immunocompetent vs immunocompromised), and this often differed from their WBC count. On the basis of our observations, we conclude that the ImmuKnow assay is a simple and fast immune-monitoring technique for patients undergoing alloHSCT, with potential to predict clinical course and facilitate prompt management of post-HSCT complications. The assay should be evaluated prospectively in clinical trials.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Busca A, Lovisone E, Aliberti S, Locatelli F, Serra A, Scaravaglio P et al. Immune reconstitution and early infectious complications following nonmyeloablative hematopoietic stem cell transplantation. Hematology 2003; 8: 303–311.

    Article  CAS  PubMed  Google Scholar 

  2. Ball LM, Lankester AC, Bredius RG, Fibbe WE, van Tol MJ, Egeler RM et al. Graft dysfunction and delayed immune reconstitution following haploidentical peripheral blood hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 35 (Suppl 1): S35–S38.

    Article  PubMed  Google Scholar 

  3. Wu CJ, Ritz J . Induction of tumor immunity following allogeneic stem cell transplantation. Adv Immunol 2006; 90: 133–173.

    Article  CAS  PubMed  Google Scholar 

  4. Kristt D, Stein J, Yaniv I, Klein T . Assessing quantitative chimerism longitudinally: technical considerations, clinical applications and routine feasibility. Bone Marrow Transplant 2007; 39: 255–268.

    Article  CAS  PubMed  Google Scholar 

  5. Kowalski RJ, Post DR, Mannon RB, Sebastian A, Wright HI, Sigle G et al. Assessing relative risks of infection and rejection: a meta-analysis using immune function assay. Transplantation 2006; 39: 663–668.

    Article  Google Scholar 

  6. Israeli M, Yussim A, Mor E, Sredni B, Klein I . Preceeding the rejection: in search for a comprehensive post-transplant immune monitoring platform. Transpl Immunol 2007; 18: 7–12.

    Article  PubMed  Google Scholar 

  7. Rodrigo E, Arias M . A practical approach to immune monitoring in kidney transplantation. Minerva Urol Nefrol 2007; 59: 337–352.

    CAS  PubMed  Google Scholar 

  8. Jin Y, Hernandez A, Fuller L, Rosen A, Cirocco R, Esquenazi V et al. A novel approach to detect donor/ recipient immune responses between HLA-identical pairs. Hum Immunol 2007; 68: 350–361.

    Article  CAS  PubMed  Google Scholar 

  9. Cadillo-Chávez R, de Echegaray S, Santiago-Delpín EA, Rodríguez-Trinidad AT, Camacho-Carrazo B, Alfaro T . Assessing the risk of infection and rejection in Hispanic renal transplant recipients by means of an adenosine triphosphate release assay. Transplant Proc 2006; 38: 918–920.

    Article  PubMed  Google Scholar 

  10. Lee TC, Goss JA, Rooney CM, Heslop HE, Barshes NR, Caldwell YM . Quantification of a low cellular immune response to aid in identification of pediatric liver transplant recipients at high-risk for EBV infection. Clin Transplant 2006; 20: 689–694.

    Article  PubMed  Google Scholar 

  11. Zeevi A, Husain S, Spichty KJ, Raza K, Woodcock JB, Zaldonis D . Recovery of functional memory T cells in lung transplant recipients following induction therapy with alemtuzumab. Am J Transplant 2007; 7: 471–475.

    Article  CAS  PubMed  Google Scholar 

  12. Visner GA, Goldfarb SB . Post-transplant monitoring of pediatric lung transplant recipients. Curr Opin Pediatr 2007; 19: 321–326.

    Article  PubMed  Google Scholar 

  13. Zeevi A, Britz JA, Bentlejewski CA, Guaspari D, Tong W, Bond G et al. Monitoring immune function during tacrolimustapering in small bowel transplant recipients. Transpl Immunol 2005; 15: 17–24.

    Article  CAS  PubMed  Google Scholar 

  14. Thai NL, Blisard D, Tom K, Basu A, Smetanka C, Tan H et al. Pancreas transplantation under alemtuzumab (Campath-1H) and tacrolimus: correlation between low T-cell responses and infection. Transplantation 2006; 18: 1649–1652.

    Article  Google Scholar 

  15. Knight RJ, Kerman RH, McKissick E, Lawless A, Podder H, Katz S et al. A pilot study of immuno-suppression minimization after pancreas-kidney transplantation utilizing thymoglobulin induction and sirolimus maintenance therapy. Transplant Proc 2005; 37: 3538–3541.

    Article  CAS  PubMed  Google Scholar 

  16. Kowalski RJ, Post DR, Mannon RB, Sebastian A, Wright HI, Sigle G et al. Assessing relative risks of infection and rejection: a meta-analysis using an immune function assay. Transplantation 2006; 82: 663–668. Comment in: Nat Clin Pract Nephrol. 2007; 3:196-7.

    Article  PubMed  Google Scholar 

  17. Kowalski R, Post D, Schneider MC, Britz J, Thomas J, Deierhoi M et al. Immune cell function testing: an adjunct to therapeutic drug monitoring in transplant patient management. Clin Transplant 2003; 17: 77–88.

    Article  PubMed  Google Scholar 

  18. Pacheco-Silva A . Immune function, as assessed by the ImmuKnow assay, correlates with clinical outcomes in transplant recipients. Nat Clin Pract Nephrol 2007; 3: 196–197.

    Article  PubMed  Google Scholar 

  19. Hooper E, Hawkins DM, Kowalski RJ, Post DR, Britz JA, Brooks KC et al. Establishing pediatric immune response zones using the Cylex ImmuKnow assay. Clin Transplant 2005; 19: 834–839.

    Article  CAS  PubMed  Google Scholar 

  20. Or R, Shapira MY, Resnick I, Amar A, Acherstein A, Samuel S et al. Nonmyeloablative allogeneic stem cell transplantation for the treatment of chronic myeloid leukemia in the first chronic phase. Blood 2003, 441–445.

    Article  PubMed  Google Scholar 

  21. Chen X, Hale GA, Barfield R, Benaim E, Leung WH, Knowles J et al. Rapid immune reconstitution after a reduced-intensity conditioning regimen and a CD3-depleted haploidentical stem cell graft for paediatric refractory haematological malignancies. Br J Haematol 2006; 135: 524–532.

    Article  PubMed  Google Scholar 

  22. Bleyer WA, Blaese RM, Bujak JS, Herzig GP, Graw Jr RG . Long-term remission from acute myelogenous leukemia after bone marrow transplantation and recovery from acute graft-versus-host reaction and prolonged immunoincompetence. Blood 1975; 45: 171–181.

    CAS  PubMed  Google Scholar 

  23. Chen X, Hale GA, Neale GA, Knowles J, Barfield RC, Wang YD et al. A novel approach for the analysis of T-cell reconstitution by using a T-cell receptor beta-based oligonucleotide microarray in hematopoietic stem cell transplantation. Exp Hematol 2007; 35: 831–841.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was partly supported by Teva Medical Ltd. We thank Mrs Sharon Pantel-Bakst and Dr Mario Baras for data analysis and statistical evaluation; Mrs Lilly Schaechter, Mrs Yifat Saydoff and Mr Jaakov Bar for their help with the preparation of the article.

Author information

Authors and Affiliations

  1. Department of Bone Marrow Transplantation, Cancer Immunotherapy & Immunobiology Research Center, Hadassah Hebrew University Medical Center, Jerusalem, Israel

    B Gesundheit, E Budowski, M Y Shapira, I B Resnick, R Bringer, Y Azar, S Samuel, L Dray & R Or

  2. CAIR Institute, Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel

    M Israeli

  3. Laboratory of Histocompatibility and Immunogenetics, Hadassah Hebrew University Medical Center, Jerusalem, Israel

    A Amar

  4. Molecular Pathology Program, Laboratory of Histocompatibility and Immunogenetics, Rabin Medical Center, Petach Tikvah, Israel

    D Kristt

Authors
  1. B Gesundheit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E Budowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M Israeli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Y Shapira
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I B Resnick
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. R Bringer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y Azar
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. S Samuel
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. L Dray
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. A Amar
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. D Kristt
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. R Or
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R Or.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gesundheit, B., Budowski, E., Israeli, M. et al. Assessment of CD4 T-lymphocyte reactivity by the Cylex ImmuKnow assay in patients following allogeneic hematopoietic SCT. Bone Marrow Transplant 45, 527–533 (2010). https://doi.org/10.1038/bmt.2009.182

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2009.182

Keywords

This article is cited by

Search

Advanced search

Quick links