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Post-Transplant Events

Lack of prompt expansion of cytomegalovirus pp65 and IE-1-specific IFNγ CD8+ and CD4+ T cells is associated with rising levels of pp65 antigenemia and DNAemia during pre-emptive therapy in allogeneic hematopoietic stem cell transplant recipients

Bone Marrow Transplantation volume 45, pages 543–549 (2010)Cite this article

Abstract

Rising levels of cytomegalovirus (CMV) DNAemia and/or pp65 antigenemia have been observed during pre-emptive ganciclovir therapy in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT). We assessed the incidence of this event in our series, and investigated whether its occurrence was associated with an impairment in the CMV-specific T-cell response. A total of 36 allo-SCT recipients experienced one or more episodes of active CMV infection (n=68) that were pre-emptively treated with val(ganciclovir). Rising levels of antigenemia and DNAemia, and an isolated increase in antigenemia, were observed in 39.7 and 2.9% of all episodes, respectively. Receipt of corticosteroids was associated with rising levels of antigenemia and DNAemia. Median increases of 12- and 6.8-fold of IFNγ CD8+ T and IFNγ CD4+ T cells, respectively, were observed at a median of 16.5 days after initiation of therapy in episodes with decreasing levels in antigenemia and DNAemia. In contrast, the numbers of both T-cell subsets at a median of 13.5 days after initiation of therapy did not differ significantly from those of pre-treatment samples in episodes with rising levels of antigenemia and DNAemia. Lack of prompt expansion of CMV pp65 and IE-1-specific IFNγ CD8+ and CD4+ T cells is associated with rising levels in antigenemia and DNAemia during pre-emptive therapy.

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Acknowledgements

We thank all the internal fellow staff of the Microbiology Service of Hospital Clínico Universitario for technical assistance. This research was supported by a grant (06/1738) from FIS (Fondo de Investigaciones Sanitarias, Ministerio de Sanidad y Consumo, Spain).

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Authors and Affiliations

  1. Microbiology Service, Hospital Clínico Universitario, Valencia, Spain

    N Tormo, M A Clari, C Gimeno & D Navarro

  2. Hematology and Medical Oncology Service, Hospital Clínico Universitario, Valencia, Spain

    C Solano, I Benet, J C Hernández-Boluda & M J Remigia

  3. Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain

    C Solano

  4. Hematology Service, Hospital Morales Meseguer, Murcia, Spain

    J Nieto

  5. Hematology Service, Hospital de La Princesa, Madrid, Spain

    R de la Cámara & A Garcia-Noblejas

  6. Hematology Service, Hospital Ramón y Cajal, Madrid, Spain

    J López

  7. Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain

    N López-Aldeguer, C Gimeno & D Navarro

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  1. N Tormo
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  2. C Solano
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  9. J C Hernández-Boluda
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Correspondence to D Navarro.

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Tormo, N., Solano, C., Benet, I. et al. Lack of prompt expansion of cytomegalovirus pp65 and IE-1-specific IFNγ CD8+ and CD4+ T cells is associated with rising levels of pp65 antigenemia and DNAemia during pre-emptive therapy in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 45, 543–549 (2010). https://doi.org/10.1038/bmt.2009.172

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