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Torque teno virus in patients undergoing allogeneic hematopoietic stem cell transplantation for hematological malignancies

Bone Marrow Transplantation volume 51, pages 440–442 (2016)Cite this article

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Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) for hematological malignancies are at high risk of infections.1 The synergy of transplant conditioning and allogeneic effect of the graft will destroy the patient’s immune system and in particular antiviral immunity may be impeded for a substantial period of time. Moreover, many patients may already have slumbering viral infections at transplant because the disease and its treatment have weakened their immune system. Immunocompetence is difficult to quantify but surrogate markers may help in assessing the degree of the patient’s immunodeficiency. The number of CD4-positive T cells is such a marker but it may be inaccurate in patients going through multiple periods of chemotherapy-2 or transplant conditioning-induced lymphopenia because the number of T cells may normalize without restoring immunity.3 It is obvious that the level of the patient’s immunocompetence is assessed best based on his genuine capacity to defend himself against infections.

Torque teno virus (TTV) is a small non-enveloped, single-stranded DNA Anellovirus that infects humans early in life.4, 5, 6 Reports on the prevalence in the general population vary greatly, most likely owing to the different thresholds of the PCR techniques used for the detection of the viral genome.6 It is currently believed that >90% of the population is infected but that the viral load in blood may remain undetectable because genome replication is efficiently controlled by the immune system. The latter is clearly illustrated by the fact that the viral load increases greatly after immune suppression given to prevent rejection of transplanted organs7, 8 and that high copy numbers are present in the blood during secondary immune deficiencies in patients with AIDS9 or after HSCT.10, 11 As TTV is not sensitive to current antiviral prophylaxis/therapy,8 the number of viral copies in the patient’s blood may be an appropriate parameter to measure immunocompetence.

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Acknowledgements

ER is supported by grants of the Swiss National Science Foundation and of the Swiss Cancer Research foundation.

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Authors and Affiliations

  1. Division of Hematology, Stem Cell Transplant Team, Geneva University Hospital, Geneva, Switzerland

    S Masouridi-Levrat, F Simonetta & Y Chalandon

  2. Division of Hematology, Geneva University Hospital and Geneva Medical School, Geneva, Switzerland

    A Pradier & E Roosnek

  3. Division of Infectious Diseases, Laboratory of Virology and Division of Laboratory Medicine, University Hospital of Geneva, Geneva, Switzerland

    L Kaiser

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  1. S Masouridi-Levrat
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Correspondence to E Roosnek.

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Masouridi-Levrat, S., Pradier, A., Simonetta, F. et al. Torque teno virus in patients undergoing allogeneic hematopoietic stem cell transplantation for hematological malignancies. Bone Marrow Transplant 51, 440–442 (2016). https://doi.org/10.1038/bmt.2015.262

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