BACKGROUND: Cytomegalovirus (CMV) infections in hematopoietic cell transplant (HCT) recipients cause substantial morbidity and mortality. CMV cell-mediated immunity (CMV-CMI) can be determined by levels of interferon gamma (IFN-γ) production using an enzyme-linked immunospot (ELISPOT) CMV assay (T-SPOT.CMV assay). In this study, we evaluated the ability of this assay to predict the outcome of low-level CMV reactivation in HCT recipients. METHODS: We followed 55 HCT recipients with low-level CMV reactivation up to 8 weeks from enrollment. Progression to clinically significant CMV infection (CS-CMVi) was defined as a CMV load >1000 IU/mL or > 500 IU/mL in patients receiving matched related/autologous or matched unrelated transplants, respectively, and initiation of antiviral treatment. RESULTS: Progression to CS-CMVi occurred in 31 (56%) of the HCT recipients. Spot counts of CMV-specific pp65 and IE1 antigens were significantly lower in patients who had CS-CMVi than in patients who did not. On multivariate analysis, the ELISPOT CMV responses and steroids use were the only predictors of progression to CS-CMVi. CONCLUSIONS: A strong association between low CMV-CMI and progression to CS-CMVi was observed in HCT recipients. The implementation of serial monitoring of CMV-CMI may identify patients at risk of progression to CS-CMVi that require antiviral therapy.
BACKGROUND:Cytomegalovirus (CMV) infections in hematopoietic cell transplant (HCT) recipients cause substantial morbidity and mortality. CMV cell-mediated immunity (CMV-CMI) can be determined by levels of interferon gamma (IFN-γ) production using an enzyme-linked immunospot (ELISPOT) CMV assay (T-SPOT.CMV assay). In this study, we evaluated the ability of this assay to predict the outcome of low-level CMV reactivation in HCT recipients. METHODS: We followed 55 HCT recipients with low-level CMV reactivation up to 8 weeks from enrollment. Progression to clinically significant CMV infection (CS-CMVi) was defined as a CMV load >1000 IU/mL or > 500 IU/mL in patients receiving matched related/autologous or matched unrelated transplants, respectively, and initiation of antiviral treatment. RESULTS: Progression to CS-CMVi occurred in 31 (56%) of the HCT recipients. Spot counts of CMV-specific pp65 and IE1 antigens were significantly lower in patients who had CS-CMVi than in patients who did not. On multivariate analysis, the ELISPOT CMV responses and steroids use were the only predictors of progression to CS-CMVi. CONCLUSIONS: A strong association between low CMV-CMI and progression to CS-CMVi was observed in HCT recipients. The implementation of serial monitoring of CMV-CMI may identify patients at risk of progression to CS-CMVi that require antiviral therapy.
Authors: P Ljungman; R de la Camara; C Cordonnier; H Einsele; D Engelhard; P Reusser; J Styczynski; K Ward Journal: Bone Marrow Transplant Date: 2008-06-30 Impact factor: 5.483
Authors: María Ángeles Clari; Beatriz Muñoz-Cobo; Carlos Solano; Isabel Benet; Elisa Costa; María José Remigia; Dayana Bravo; Paula Amat; David Navarro Journal: Clin Vaccine Immunol Date: 2012-02-29
Authors: S Cantisán; R Lara; M Montejo; J Redel; A Rodríguez-Benot; J Gutiérrez-Aroca; M González-Padilla; L Bueno; A Rivero; R Solana; J Torre-Cisneros Journal: Am J Transplant Date: 2013-01-11 Impact factor: 8.086
Authors: S Walker; C Fazou; T Crough; R Holdsworth; P Kiely; M Veale; S Bell; A Gailbraith; K McNeil; S Jones; R Khanna Journal: Transpl Infect Dis Date: 2007-06 Impact factor: 2.228
Authors: Per Ljungman; Michael Boeckh; Hans H Hirsch; Filip Josephson; Jens Lundgren; Garrett Nichols; Andreas Pikis; Raymund R Razonable; Veronica Miller; Paul D Griffiths Journal: Clin Infect Dis Date: 2016-09-28 Impact factor: 9.079
Authors: Oriol Manuel; Shahid Husain; Deepali Kumar; Carlos Zayas; Steve Mawhorter; Marilyn E Levi; Jayant Kalpoe; Luiz Lisboa; Leticia Ely; Daniel R Kaul; Brian S Schwartz; Michele I Morris; Michael G Ison; Belinda Yen-Lieberman; Anthony Sebastian; Maha Assi; Atul Humar Journal: Clin Infect Dis Date: 2012-11-29 Impact factor: 9.079
Authors: Roy F Chemaly; Lynn El Haddad; Drew J Winston; Scott D Rowley; Kathleen M Mulane; Pranatharthi Chandrasekar; Robin K Avery; Parameswaran Hari; Karl S Peggs; Deepali Kumar; Rajneesh Nath; Per Ljungman; Sherif B Mossad; Sanjeet S Dadwal; Ted Blanchard; Dimpy P Shah; Ying Jiang; Ella Ariza-Heredia Journal: Clin Infect Dis Date: 2020-12-03 Impact factor: 9.079
Authors: Corey Smith; Dillon Corvino; Leone Beagley; Sweera Rehan; Michelle A Neller; Pauline Crooks; Katherine K Matthews; Matthew Solomon; Laetitia Le Texier; Scott Campbell; Ross S Francis; Daniel Chambers; Rajiv Khanna Journal: J Clin Invest Date: 2019-11-01 Impact factor: 14.808
Authors: Lynn El Haddad; Shashank S Ghantoji; Anne K Park; Marjorie V Batista; Jonathan Schelfhout; Jack Hachem; Yadira Lobo; Ying Jiang; Gabriela Rondon; Richard Champlin; Roy F Chemaly Journal: J Med Virol Date: 2019-09-03 Impact factor: 2.327
Authors: Joseph Sassine; Fareed Khawaja; Terri Lynn Shigle; Victoria Handy; Farnaz Foolad; Samuel L Aitken; Ying Jiang; Richard Champlin; Elizabeth Shpall; Katy Rezvani; Ella J Ariza-Heredia; Roy F Chemaly Journal: Clin Infect Dis Date: 2021-10-20 Impact factor: 9.079