title: Cytomegalovirus viral load and virus-specific immune reconstitution after peripheral blood stem cell versus bone marrow transplantation.
abstract: Peripheral blood stem cell (PBSC) products contain more T cells and monocytes when compared with bone marrow (BM), leading to fewer bacterial and fungal infections. Cytomegelovirus (CMV) viral load and disease as well as CMV-specific immune reconstitution were compared in patients enrolled in a randomized trial comparing PSBC and BM transplantation. There was a higher rate of CMV infection and disease during the first 100 days after transplantation among PBSC recipients (any antigenemia/DNAemia: PBSC, 63% vs BM, 42%, P = .04; CMV disease: PBSC, 17% vs BM, 4%, P = .03). By 2 years, CMV disease rates were similar. The early increase in CMV events correlated temporarily with lower CMV-specific CD4(+) T helper and CD8(+) cytotoxic T lymphocyte function at 30 days after transplantation in PBSC recipients. By 3 months after transplantation and thereafter, CMV-specific immune responses were similar between BM and PBSC recipients. In conclusion, higher CMV infection and disease rates occurred in PBSC transplant recipients early after transplantation. These differences may be because of a transient delay in CMV-specific immune reconstitution following PBSC transplantation.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
authors.forename: Abraham
authors.initials: A
authors.lastname: Guerrero
authors.forename: Stanley R
authors.initials: SR
authors.lastname: Riddell
authors.forename: Jan
authors.initials: J
authors.lastname: Storek
authors.forename: Terry
authors.initials: T
authors.lastname: Stevens-Ayers
authors.forename: Barry
authors.initials: B
authors.lastname: Storer
authors.forename: John A
authors.initials: JA
authors.lastname: Zaia
authors.forename: Stephen
authors.initials: S
authors.lastname: Forman
authors.forename: Robert S
authors.initials: RS
authors.lastname: Negrin
authors.forename: Thomas
authors.initials: T
authors.lastname: Chauncey
authors.forename: William
authors.initials: W
authors.lastname: Bensinger
authors.forename: Michael
authors.initials: M
authors.lastname: Boeckh
mesh_terms: D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000276:immunology* / Q000379:methods; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D002648:Child; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology; D003587:Cytomegalovirus / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000276:immunology* / Q000821:virology; D006801:Humans; D008875:Middle Aged; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D013601:T-Lymphocytes / Q000276:immunology*; D019562:Viral Load; D055815:Young Adult
chemical_list: D016207:Cytokines