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| Article Authors: | Sylvia Borchers; Melanie Bremm; Thomas Lehrnbecher; Elke Dammann; Brigitte Pabst; Benno Wölk; Ruth Esser; Meral Yildiz; Matthias Eder; Michael Stadler; Peter Bader; Hans Martin; Andrea Jarisch; Gisbert Schneider; Thomas Klingebiel; Arnold Ganser; Eva M Weissinger; Ulrike Koehl |
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| Article Title: | Sequential anti-cytomegalovirus response monitoring may allow prediction of cytomegalovirus reactivation after allogeneic stem cell transplantation. |
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| Reference ID: | 1025397 |
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| Abstract: | BACKGROUND: Reconstitution of cytomegalovirus-specific CD3(+)CD8(+) T cells (CMV-CTLs) after allogeneic hematopoietic stem cell transplantation (HSCT) is necessary to bring cytomegalovirus (CMV) reactivation under control. However, the parameters determining protective CMV-CTL reconstitution remain unclear to date. DESIGN AND METHODS: In a prospective tri-center study, CMV-CTL reconstitution was analyzed in the peripheral blood from 278 patients during the year following HSCT using 7 commercially available tetrameric HLA-CMV epitope complexes. All patients included could be monitored with at least CMV-specific tetramer. RESULTS: CMV-CTL reconstitution was detected in 198 patients (71%) after allogeneic HSCT. Most importantly, reconstitution with 1 CMV-CTL per µl blood between day +50 and day +75 post-HSCT discriminated between patients with and without CMV reactivation in the R+/D+ patient group, independent of the CMV-epitope recognized. In addition, CMV-CTLs expanded more daramtaically in patients experiencing only one CMV-reactivation than those without or those with multiple CMV reactivations. Monitoring using at least 2 tetramers was possible in 63% (n = 176) of the patients. The combinations of particular HLA molecules influenced the numbers of CMV-CTLs detected. The highest CMV-CTL count obtained for an individual tetramer also changed over time in 11% of these patients (n = 19) resulting in higher levels of HLA-B*0801 (IE-1) recognizing CMV-CTLs in 14 patients. CONCLUSIONS: Our results indicate that 1 CMV-CTL per µl blood between day +50 to +75 marks the beginning of an immune response against CMV in the R+/D+ group. Detection of CMV-CTL expansion thereafter indicates successful resolution of the CMV reactivation. Thus, sequential monitoring of CMV-CTL reconstitution can be used to predict patients at risk for recurrent CMV reactivation. |
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| Affiliations: | Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany. |
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| Date: | 2012 |
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| Reference Type: | Literature |
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| PubMed ID: | 23272059 |
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| Journal: | PLoS One |
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| Journal Volume: | 7 |
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| Article Pages: | e50248 |
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| Journal ISSN: | 1932-6203 |
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| Curation Last Updated: | 2013-02-14 20:01:30 |
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