Monitoring cytomegalovirus IE-1 and pp65-specific CD4+ and CD8+ T-cell responses after allogeneic stem cell transplantation may identify patients at risk for recurrent CMV reactivations

✍ Scribed by Jan W. Gratama; Rik A. Brooimans; Bronno van der Holt; Kees Sintnicolaas; Gerard van Doornum; Hubertus G. Niesters; Bob Löwenberg; Jan J. Cornelissen

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 298 KB
• Volume: 74B
• Category: Article
• ISSN: 1552-4949
• DOI: 10.1002/cyto.b.20420

✦ Synopsis

Abstract

We studied the recovery of CMV‐specific CD4^+^ and CD8^+^ T‐cell immunity in 52 recipients of allogeneic stem cell transplantation (SCT). The proportions of IFN‐γ‐producing CD4^+^ and CD8^+^ T cells upon in vitro activation using peptide pools representing the CMV pp65 and IE‐1 proteins were assessed at multiple time points post SCT, and correlated with the occurrence of CMV reactivation. In a retrospective analysis, recurrent CMV reactivations occurred in 9 patients and were associated with low pp65‐specific CD4^+^ T‐cell and low IE‐1‐specific CD8^+^ T‐cell reactivities, whereas patients without detectable CMV reactivation (n = 30) or a single reactivation (n = 13) showed a better recovery of these immune responses. CD4^+^ T‐cell responses to IE‐1 were infrequent in most patients, whereas CD8^+^ T‐cell responses to pp65 occurred frequently, but did not correlate with protection against (recurrent) reactivation. Prospectively, CMV‐specific T‐cell responses could be studied prior to 14 reactivation episodes in 8 patients. CD4^+^ T‐cell responses to IE‐1 and pp65 were positive in only 1 and 2 episodes, respectively. CD8^+^ T‐cell responses against IE‐1 were positive in 4, but against pp65 in 12 episodes, again showing that CD8^+^ T‐cell reactivity against pp65 did not prevent CMV reactivation. Thus, monitoring of particular CMV‐specific CD4^+^ and CD8^+^ T‐cell responses after allogeneic SCT may identify patients at risk for recurrent CMV reactivations. © 2008 Clinical Cytometry Society