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Lack of prompt expansion of cytomegalovirus pp65 and IE-1-specific IFN[gamma] [CD8.sup.+] and [CD4.sup.+] T cells is associated with rising levels of pp65 antigenemia and DNAemia during pre-emptive therapy in allogeneic hematopoietic stem cell transplant recipients
Ist Teil von
Bone marrow transplantation (Basingstoke), 2010-03, Vol.45 (3), p.543
Ort / Verlag
Nature Publishing Group
Erscheinungsjahr
2010
Quelle
Alma/SFX Local Collection
Beschreibungen/Notizen
Rising levels of cytomegalovirus (CMV) DNAemia and/or pp65 antigenemia have been observed during pre-emptive ganciclovir therapy in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-SCT). We assessed the incidence of this event in our series, and investigated whether its occurrence was associated with an impairment in the CMV-specific T-cell response. A total of 36 allo-SCT recipients experienced one or more episodes of active CMV infection (n = 68) that were preemptively treated with val(ganciclovir). Rising levels of antigenemia and DNAemia, and an isolated increase in antigenemia, were observed in 39.7 and 2.9% of all episodes, respectively. Receipt of corticosteroids was associated with rising levels of antigenemia and DNAemia. Median increases of 12- and 6.8-fold of IFN[gamma] [CD8.sup.+] T and IFN[gamma] [CD4.sup.+] T cells, respectively, were observed at a median of 16.5 days after initiation of therapy in episodes with decreasing levels in antigenemia and DNAemia. In contrast, the numbers of both T-cell subsets at a median of 13.5 days after initiation of therapy did not differ significantly from those of pre-treatment samples in episodes with rising levels of antigenemia and DNAemia. Lack of prompt expansion of CMV pp65 and IE-1-specific IFN[gamma] [CD8.sup.+] and [CD4.sup.+] T cells is associated with rising levels in antigenemia and DNAemia during pre-emptive therapy. Bone Marrow Transplantation (2010) 45, 543-549; doi: 10.1038/bmt.2009.172; published online 20 July 2009 Keywords: cytomegalovirus; IFN[gamma] [CD8.sup.+] and [CD4.sup.+] T cells rising antigenemia; stem cell transplantation