title: CMV-specific immune reconstitution following allogeneic stem cell transplantation.
abstract: Cytomegalovirus (CMV) remains a major contributor to morbidity and mortality following allogeneic haemopoietic stem cell transplant (HSCT) despite widespread use of viraemia monitoring and pre-emptive antiviral therapy. Uncontrolled viral replication occurs primarily in the first 100 d post transplant but this high risk period can extend to many months if immune recovery is delayed. The re-establishment of a functional population of cellular effectors is essential for control of virus replication and depends on recipient and donor serostatus, the stem cell source, degree of HLA matching and post-transplant factors such as CMV antigen exposure, presence of GVHD and ongoing use of immune suppression. A number of immune monitoring assays exist but have not yet become widely accessible for routine clinical use. Vaccination, adoptive transfer of CMV specific T cells and a number of graft engineering processes are being evaluated to enhance of CMV specific immune recovery post HSCT.
authors: a Westmead Institute for Medical Research at the University of Sydney , Westmead , Sydney , Australia.|b Blood and Marrow Transplant Unit, Westmead Hospital , Sydney , Australia.|c Department of Haematology , Westmead , Sydney , Australia.
authors: Emily
authors: E
authors: Blyth
authors: a Westmead Institute for Medical Research at the University of Sydney , Westmead , Sydney , Australia.
authors: Barbara
authors: B
authors: Withers
authors: a Westmead Institute for Medical Research at the University of Sydney , Westmead , Sydney , Australia.|d Sydney Cellular Therapies Laboratory , Westmead , Sydney , Australia.
authors: Leighton
authors: L
authors: Clancy
authors: a Westmead Institute for Medical Research at the University of Sydney , Westmead , Sydney , Australia.|b Blood and Marrow Transplant Unit, Westmead Hospital , Sydney , Australia.|c Department of Haematology , Westmead , Sydney , Australia.|d Sydney Cellular Therapies Laboratory , Westmead , Sydney , Australia.
authors: David
authors: D
authors: Gottlieb
mesh_terms: D019264:Adoptive Transfer; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000276:immunology* / Q000502:physiology; D003586:Cytomegalovirus Infections / Q000276:immunology*; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D014611:Vaccination; D014779:Virus Replication
chemical_list: D000998:Antiviral Agents
keywords: CMV immunity; Cytomegalovirus; adoptive T cell transfer; haemopoietic stem cell transplantation; immunotherapy