Abstract:
:Lack of virus-specific cell-mediated immunity (CMI) is associated with worse viral infection outcome in hematopoietic stem cell transplantation (HSCT). We aimed to evaluate the role of immunological monitoring of Epstein-Barr virus (EBV) infection in addition to virological one in 33 adult and 18 pediatric allogeneic HSCT recipients. Virological monitoring of infection was performed on whole blood samples by a quantitative real-time PCR assay. Immunological monitoring was performed by Enzyme-linked ImmunoSPOT assay, evaluating EBV-specific CMI, at fixed time-points and when EBV DNAemia was ≥ 10,000 copies/mL. Fifty-one percent of patients developed a post-transplant EBV infection and reduced-intensity conditioning regimen was the only factor associated to infection (P = 0.023). Lack of EBV-specific CMI during active EBV infection was associated with a greater severity of infection. Patients without EBV-specific CMI showed higher median peak level of EBV DNAemia than patients with EBV-specific CMI (P = 0.014), and consequently received more frequently, at EBV DNAemia peak, anti-CD20 therapy (0 versus 54.5%, P = 0.002). No patients with EBV-specific CMI versus 27.2% without EBV-specific CMI developed EBV-related complications (P = 0.063), including two lethal EBV-related post-transplant lymphoproliferative disorders. Combined immunological and virological measurements could improve EBV infection management in HSCT, anticipating the beginning of preemptive treatment from the EBV DNAemia peak to the finding of the lack of EBV-specific CMI.
journal_name
Med Microbiol Immunoljournal_title
Medical microbiology and immunologyauthors
Chiereghin A,Piccirilli G,Belotti T,Prete A,Bertuzzi C,Gibertoni D,Gabrielli L,Turello G,Borgatti EC,Barbato F,Sessa M,Arpinati M,Bonifazi F,Lazzarotto Tdoi
10.1007/s00430-019-00629-2subject
Has Abstractpub_date
2019-12-01 00:00:00pages
825-834issue
6eissn
0300-8584issn
1432-1831pii
10.1007/s00430-019-00629-2journal_volume
208pub_type
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