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Abstract
The detailed kinetics of the cytomegalovirus (CMV)-specific T cell response in hematopoietic stem cell transplant (HCT) recipients have not yet been fully assessed. We evaluated these kinetics of CMV-specific T cell response and factors associated with high CMV-specific T cell responses 1 year after HCT. In HCT recipients, CMV pp65 and IE1-specific ELISPOT assay were performed before HCT (D0), and at 30 (D30), 90 (D90), 180 (D180), and 360 (D360) days after HCT. Of the 51 HCT recipients with donor-positive (D+)/recipient-positive (R+) serology, 26 (51%) developed CMV infections after HCT. The patterns of post-transplantation reconstitution for CMV-specific T cell response were classified into 4 types: 1) an initial decrease at D30 followed by gradual T cell reconstitution without CMV infection (35%), 2) an initial decrease at D30 followed by gradual T cell reconstitution preceded by CMV infection (35%), 3) failure of gradual or constant T cell reconstitution (26%), and 4) no significant T cell reconstitution (4%). There was no significant difference between ELISPOT counts of D360 and those of D0. High CMV-specific T cell responses at D360 were not associated with high CMV-specific T cell response at D0, CMV infection, ganciclovir therapy, graft versus host disease (GVHD), and immunosuppressant use. In conclusion, there are 4 distinct patterns of reconstitution of the CMV-specific T cell response after HCT. In addition, reconstituted donor-origin CMV-specific T cell responses appeared to be constant until day 360 after HCT, regardless of the level of the pre-transplant CMV-specific T cell response, CMV infection, and immunosuppressant use.
References
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Figure 1.
Kinetics of (A) pp65- and (B) IE1-specific ELISPOT assays over the first year after transplantation in hematopoietic stem cell recipients. Bars indicate median values. Only significant p-values are shown. PBMC, peripheral blood mononuclear cell. * p<0.05.
Figure 2.
Four patterns of immune reconstitution in hematopoietic stem cell recipients. (A) Spontaneous recovery without CMV infection. (B) T cell reconstitution with a preceding CMV infection. (C) Failure of gradual or sustained T cell reconstitution. (D) Absence of T cell reconstitution. PBMC, peripheral blood mononuclear cell.
Table 1.
Baseline demographic and clinical characteristics of 51 recipients of HCTs
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