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

被引:0
作者
N Tormo
C Solano
I Benet
M A Clari
J Nieto
R de la Cámara
J López
N López-Aldeguer
J C Hernández-Boluda
M J Remigia
A Garcia-Noblejas
C Gimeno
D Navarro
机构
[1] Microbiology Service,Department of Medicine
[2] Hospital Clínico Universitario,Department of Microbiology
[3] Hematology and Medical Oncology Service,undefined
[4] Hospital Clínico Universitario,undefined
[5] School of Medicine,undefined
[6] University of Valencia,undefined
[7] Hematology Service,undefined
[8] Hospital Morales Meseguer,undefined
[9] Hematology Service,undefined
[10] Hospital de La Princesa,undefined
[11] Hematology Service,undefined
[12] Hospital Ramón y Cajal,undefined
[13] School of Medicine,undefined
[14] University of Valencia,undefined
来源
Bone Marrow Transplantation | 2010年 / 45卷
关键词
cytomegalovirus; IFNγ CD8; and CD4; T cells; rising antigenemia; stem cell transplantation;
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摘要
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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页码:543 / 549
页数:6
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