TY  - JOUR
A1  - Borchers, Sylvia
A1  - Bremm, Melanie
A1  - Lehrnbecher, Thomas
A1  - Dammann, Elke
A1  - Pabst, Brigitte
A1  - Wölk, Benno
A1  - Esser, Ruth
A1  - Yildiz, Meral
A1  - Eder, Matthias
A1  - Stadler, Michael
A1  - Bader, Peter
A1  - Martin, Hans
A1  - Jarisch, Andrea
A1  - Schneider, Gisbert
A1  - Klingebiel, Thomas
A1  - Ganser, Arnold
A1  - Mischak-Weissinger, Eva Maria
A1  - Köhl, Ulrike
T1  - Sequential anti-cytomegalovirus response monitoring may allow prediction of cytomegalovirus reactivation after allogeneic stem cell transplantation
T2  - PLoS One
N2  - Background: Reconstitution of cytomegalovirus-specific CD3+CD8+ T cells (CMV-CTLs) after allogeneic hematopoietic stem cell transplantation (HSCT) is necessary to bring cytomegalovirus (CMV) reactivation under control. However, the parameters determining protective CMV-CTL reconstitution remain unclear to date.

Design and Methods: In a prospective tri-center study, CMV-CTL reconstitution was analyzed in the peripheral blood from 278 patients during the year following HSCT using 7 commercially available tetrameric HLA-CMV epitope complexes. All patients included could be monitored with at least CMV-specific tetramer.

Results: CMV-CTL reconstitution was detected in 198 patients (71%) after allogeneic HSCT. Most importantly, reconstitution with 1 CMV-CTL per µl blood between day +50 and day +75 post-HSCT discriminated between patients with and without CMV reactivation in the R+/D+ patient group, independent of the CMV-epitope recognized. In addition, CMV-CTLs expanded more daramtaically in patients experiencing only one CMV-reactivation than those without or those with multiple CMV reactivations. Monitoring using at least 2 tetramers was possible in 63% (n = 176) of the patients. The combinations of particular HLA molecules influenced the numbers of CMV-CTLs detected. The highest CMV-CTL count obtained for an individual tetramer also changed over time in 11% of these patients (n = 19) resulting in higher levels of HLA-B*0801 (IE-1) recognizing CMV-CTLs in 14 patients.

Conclusions: Our results indicate that 1 CMV-CTL per µl blood between day +50 to +75 marks the beginning of an immune response against CMV in the R+/D+ group. Detection of CMV-CTL expansion thereafter indicates successful resolution of the CMV reactivation. Thus, sequential monitoring of CMV-CTL reconstitution can be used to predict patients at risk for recurrent CMV reactivation.
Y1  - 2012
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/27825
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-278257
SN  - 1932-6203
N1  - Copyright: © 2012 Borchers et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 7
IS  - 12: e50248
PB  - PLoS
CY  - Lawrence, Kan.
ER  -