title: Impact on the cytomegalovirus (CMV) viral load by CMV-specific T-cell immunity in recipients of allogeneic stem cell transplantation.
abstract: Patients experience cytomegalovirus (CMV) reactivation after stem cell transplantation (SCT) and need repeated courses of pre-emptive therapy. Analysis of CMV-specific immunity might help to assess the need for antiviral therapy. Forty-eight patients were studied during the first 3 months after SCT. Peripheral blood lymphocytes were stimulated by CMV antigen, and interferon (INF)-gamma production by CD3+ and CD4+ T cells was analysed. Results were correlated to transplant factors and CMV disease. Patients with INF-gamma production by CD3+ cells at 4 weeks after SCT had lower peak viral loads than patients with no such production (P=0.03). There was a similar tendency as regards CD4+ cells (P=0.09). Patients who underwent reduced-intensity conditioning (RIC) more frequently had CD3+ (48%) and CD4+ immunity (56%) 4 weeks after SCT compared with patients who received myeloablative conditioning (CD3+ 25%; CD4+ 35%). There was no effect of stem cell source, donor type or acute graft-versus-host disease. Three of 48 patients developed CMV disease and none of them had detectable INF-gamma production. CMV-specific T-cell response is associated with a lower rate of CMV replication. RIC results in improved T-cell reconstitution. Recovery of CMV-specific immunity might be delayed in patients with CMV disease. These observations suggest that detection of CMV-specific T-cells is useful in assessing the immunity against CMV.
authors.affiliation: Department of Medicine, Division of Haematology, Karolinska Institutet, Karolinska University Hospital in Huddinge, Stockholm 14186, Sweden. Gayane.Avetisyan@ki.se
authors.forename: G
authors.initials: G
authors.lastname: Avetisyan
authors.forename: K
authors.initials: K
authors.lastname: Larsson
authors.forename: J
authors.initials: J
authors.lastname: Aschan
authors.forename: C
authors.initials: C
authors.lastname: Nilsson
authors.forename: M
authors.initials: M
authors.lastname: Hassan
authors.forename: P
authors.initials: P
authors.lastname: Ljungman
mesh_terms: D000293:Adolescent; D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D003587:Cytomegalovirus / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000276:immunology / Q000821:virology; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000096:biosynthesis; D008297:Male; D008875:Middle Aged; D033581:Stem Cell Transplantation / Q000009:adverse effects; D013601:T-Lymphocytes / Q000276:immunology*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
chemical_list: D007371:Interferon-gamma