The immunosuppressive effect of human cytomegalovirus infection in recipients of allogeneic hematopoietic stem cell transplantation.
In immune-competent individuals, human cytomegalovirus (HCMV) infection is associated with impairment of T-cell function. Our goal was to evaluate prospectively whether clinically asymptomatic HCMV infection in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients, treated pre emptively with ganciclovir, influences T-cell function as well. Mitogen-stimulated T-cell proliferative activity, together with cell surface markers, was tested in 49 patients on days + 30, + 45, + 60, and + 90 after alloHSCT and, additionally, in cases of positive HCMV pp65-antigenemia. HCMV infection was diagnosed in 19 patients. None of them developed HCMV disease. T-cell proliferative activity was significantly decreased on days when HCMV antigenemia was positive as compared to days without antigenemia. The number of pp65-positive cells negatively correlated with proliferative response. Comparison of patients who did experience HCMV infection with those who did not reveals significant decrease of T-cell proliferative activity observed on days + 30 and + 45, a time period when antigenemia was most frequently found to be positive, whereas no difference was detected on days + 60 and + 90. We conclude that, even clinically asymptomatic, HCMV infection has negative impact on T-cell proliferation capacity in alloHSCT recipients. However, pre emptive therapy with ganciclovir makes this immunosuppressive effect transient and restricted to the time of infection duration.
Giebel
S
S
Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy. sgiebel@poczta.onet.pl
Maccario
R
R
Lilleri
D
D
Zecca
M
M
Avanzini
M A
MA
Marconi
M
M
Di Cesare Merlone
A
A
Campanini
G
G
Montagna
D
D
Travaglino
P
P
Gentile
R
R
Telli
S
S
Pagliara
D
D
Holowiecki
J
J
Locatelli
F
F
D000293:Adolescent; D000328:Adult; D049109:Cell Proliferation / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D005260:Female; D015774:Ganciclovir / Q000494:pharmacology / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007108:Immune Tolerance; D007223:Infant; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008934:Mitogens / Q000494:pharmacology; D011292:Premedication; D013601:T-Lymphocytes / Q000276:immunology / Q000821:virology; D013997:Time Factors; D014184:Transplantation, Homologous
D008934:Mitogens; D015774:Ganciclovir