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Functional specific‐T‐cell expansion after first cytomegalovirus reactivation predicts viremia control in allogeneic hematopoietic stem cell transplant recipients
Author(s) -
Ciáurriz Miriam,
Beloki Lorea,
Zabalza Amaya,
Bandrés Eva,
Mansilla Cristina,
PérezValderrama Estela,
Lachén Mercedes,
RodríguezCalvillo Mercedes,
Ramírez Natalia,
Olavarría Eduardo
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12778
Subject(s) - viremia , medicine , immunology , cytomegalovirus , hematopoietic stem cell transplantation , cd8 , t cell , transplantation , cytotoxic t cell , immune system , virology , virus , viral disease , herpesviridae , biology , biochemistry , in vitro
The use of preemptive antiviral therapy to prevent cytomegalovirus ( CMV ) disease in allogeneic hematopoietic stem cell transplantation (allo‐ HSCT ) recipients might result in over‐treatment, inducing drug‐related toxicity and viral resistance. A search for predictive markers is needed to determine requirement for antiviral therapy. Clinical follow‐up, in combination with the use of streptamers ( ST s) and cytokine‐intracellular staining, could help to identify patients at high risk for CMV reactivations. To study the immune response and reactivation control by CMV ‐specific CD 8 + T‐cell ( CMV ‐ CTL ) populations, we monitored 25 patients who have undergone allo‐ HSCT by using ST multimer and intracellular cytokine staining. Our study has revealed that the presence of functional CMV ‐specific T cells, determined by early interferon γ production or by significant T‐cell expansion after first CMV reactivation, correlated with short CMV viremia duration and low number of CMV reactivations. By contrast, the absence of functional CMV ‐ CTLs does correlate with CMV recurrence. These results support that behavior of CMV ‐specific subpopulations after reactivation influences reactivations and can guide preemptive therapy.