Cytomegalovirus (CMV) infections and CMV-specific cellular immune reconstitution following reduced intensity conditioning allogeneic stem cell transplantation with Alemtuzumab
In: Bone Marrow Transplantation, Jg. 36 (2005-09-05), S. 797-802
Online
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Zugriff:
We studied the incidence and recurrence of Cytomegalovirus (CMV) infection and reactivation in 38 recipients of Alemtuzumab reduced intensity conditioning-stem cell transplantation, and used CMV-HLA tetramer studies to discover if these events correlated with recovery of circulating CMV-specific CD8+ T cells (cytotoxic T lymphocyte (CTLs)). The cumulative incidence of CMV infection was 60% at 1 year (95% CI, 45-78%) with a median reactivation time of 24 days (range 5-95 days). All patients with CMV reactivation received Ganciclovir or Foscarnet, and only one developed CMV disease. More strikingly, only 8/21 patients had relapse of CMV antigenemia. Tetramer analysis in 13 patients showed that 11 reconstituted CMV CTLs (7/11 by day 30 and 10/11 by day 90). The development of CMV infection was accompanied by a >5-fold rise of CMV CTLs. Recurrence of CMV infection occurred only in the patients who failed to generate a CTL response to the virus. Hence, recipients of SCT using Alemtuzumab-RIC are initially profoundly immunosuppressed and have a high incidence of early CMV reactivation. However, in the majority of patients, infection is transient, and antiviral T cell reconstitution is rapid. Monitoring with CMV-specific CTLs may help identify the subset of patients at risk from recurrent infection or disease.
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Cytomegalovirus (CMV) infections and CMV-specific cellular immune reconstitution following reduced intensity conditioning allogeneic stem cell transplantation with Alemtuzumab
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Autor/in / Beteiligte Person: | Brenner, Malcolm K. ; Krance, Robert A. ; Bollard, Catherine M. ; Heslop, Helen E. ; Lamba, R. ; Popat, Uday ; Carrum, George ; Myers, G.D. |
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Zeitschrift: | Bone Marrow Transplantation, Jg. 36 (2005-09-05), S. 797-802 |
Veröffentlichung: | Springer Science and Business Media LLC, 2005 |
Medientyp: | unknown |
ISSN: | 1476-5365 (print) ; 0268-3369 (print) |
DOI: | 10.1038/sj.bmt.1705121 |
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