Reconstitution of CMV pp65 and IE-1-specific IFN-γ CD8(+) and CD4(+) T-cell responses affording protection from CMV DNAemia following allogeneic hematopoietic SCT

Bone Marrow Transplant. 2011 Nov;46(11):1437-43. doi: 10.1038/bmt.2010.330. Epub 2011 Jan 17.

Abstract

Threshold levels of CMV-specific T-cell populations presumably affording protection from active CMV infection in allo-SCT recipients have been proposed, but lack extensive validation. We quantified CMV pp65 and immediate-early 1-specific IFN-γ CD8(+) and CD4(+) T cell responses at days +30, +60 and +90 after transplantation in 133 patients, and established cutoff cell levels protecting from CMV DNAemia within the first 120 days after transplantation. No patients showing IFN-γ CD8(+) or IFN-γ CD4(+) T-cell counts >1.0 and >1.2 cells/μL, respectively, developed a subsequent episode of CMV DNAemia. Initial or recurrent episodes of CMV DNAemia occurred in the face of IFN-γ T-cell levels below defined thresholds. Negative predictive values at day +30 for the IFN-γ CD8(+) and CD4(+) T-cell markers were 68.1 and 61.8%, respectively. Recipients of grafts from CMV seropositive, related or HLA-matched donors, or receiving non-myeloablative conditioning had nonsignificant tendencies to reach more frequently protective levels of both T-cell subsets at early and late (day +365) times after transplantation. The use of anti-thymocyte globulin and umbilical cord blood transplantation were associated with impaired CMV-specific T-cell reconstitution. CMV-specific IFN-γ CD8(+) and CD4(+) T-cell recovery occurred irrespective of detectable CMV DNAemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • CD4-Positive T-Lymphocytes / metabolism
  • CD4-Positive T-Lymphocytes / virology
  • CD8-Positive T-Lymphocytes / metabolism
  • CD8-Positive T-Lymphocytes / virology
  • Cytomegalovirus / genetics
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / blood*
  • Cytomegalovirus Infections / prevention & control
  • Cytomegalovirus Infections / virology
  • DNA, Viral / blood*
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immediate-Early Proteins / biosynthesis
  • Interferon-gamma / biosynthesis*
  • Male
  • Middle Aged
  • Phosphoproteins / biosynthesis*
  • Transplantation, Homologous / adverse effects
  • Viral Matrix Proteins / biosynthesis*
  • Virus Activation

Substances

  • DNA, Viral
  • Immediate-Early Proteins
  • Phosphoproteins
  • Viral Matrix Proteins
  • cytomegalovirus matrix protein 65kDa
  • Interferon-gamma