CMV seronegative donors: Effect on clinical severity of CMV infection and reconstitution of CMV-specific immunity.

Abstract:

BACKGROUND:Cytomegalovirus (CMV)-specific T-cells are crucial to prevent CMV disease. CMV seropositive recipients transplanted with stem cells from a CMV seronegative allogeneic donor (R+D-) may be at risk for CMV disease due to absence of donor CMV-specific memory T-cells in the graft. METHODS:We analyzed the duration of CMV reactivations and the incidence of CMV disease in R+D- and R+D+ patients after alemtuzumab-based T-cell depleted allogeneic stem cell transplantation (TCD alloSCT). To determine the presence of donor-derived primary CMV-specific T-cell responses we analyzed the origin of CMV-specific T-cells in R+D- patients. RESULTS:The duration of CMV reactivations (54 versus 38 days, respectively, p = 0.048) and the incidence of CMV disease (0.14 versus 0.02, p = 0.003 at 1 year after alloSCT) were higher in R+D- patients compared to R+D+ patients. In R+D- patients, CMV-specific CD4+ and CD8+ T-cells were mainly of recipient origin. However, in 53% of R+D- patients donor-derived CMV-specific T-cells were detected within the first year. CONCLUSIONS:In R+D- patients, immunity against CMV was predominantly mediated by recipient T-cells. Nevertheless, donor CMV serostatus significantly influenced the clinical severity of CMV reactivations indicating the role of CMV-specific memory T-cells transferred with the graft, despite the ultimate formation of primary donor-derived CMV-specific T-cell responses in R+D- patients.

journal_name

Transpl Immunol

journal_title

Transplant immunology

authors

van der Heiden PLJ,van Egmond HM,Veld SAJ,van de Meent M,Eefting M,de Wreede LC,Halkes CJM,Falkenburg JHF,Marijt WAF,Jedema I

doi

10.1016/j.trim.2018.04.003

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

54-58

eissn

0966-3274

issn

1878-5492

pii

S0966-3274(17)30167-3

journal_volume

49

pub_type

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