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- Title
Relationship between cytomegalovirus ( CMV) reactivation, CMV-driven immunity, overall immune recovery and graft-versus-leukaemia effect in children.
- Authors
Jeljeli, Mohamed; Guérin‐El Khourouj, Valérie; Porcher, Raphael; Fahd, Mony; Leveillé, Sandrine; Yakouben, Karima; Ouachée‐Chardin, Marie; LeGoff, Jerome; Cordeiro, Debora Jorge; Pédron, Beatrice; Baruchel, Andre; Dalle, Jean‐Hugues; Sterkers, Ghislaine
- Abstract
The interplay between immune recovery, cytomegalovirus ( CMV)-reactivation, CMV-driven immunity and graft-versus-leukaemia effect ( GVL) was analysed in 108 children (median age: 8 years) who underwent haematopoietic-stem cell transplantation ( HSCT) for acute leukaemia. Follow-up was 2 years unless death or relapse occurred. CMV-polymerase chain reaction ( PCR) was programmed weekly until month +3 post- HSCT. Immunomonitoring consisted of sequential lymphocyte subset enumerations and analyses of T-cell proliferative and γ-interferon responses to CMV and to adenovirus. In the 108 recipients, the 2-year relapse rate ( RR) was 25% (median time to onset 4·5 months; range: 24 d-17 months). CMV reactivation occurrence was 31% (median time to onset 26 d). Donor/recipient CMV serostatus did not influence RR. Among the 89 recipients disease-free after day +120, i) early CMV-reactivation before day +30 was more frequent ( P = 0·01) in the relapse recipient group opposed to the non-relapse group. ii) CD8+/ CD28− and CD4+ CD45 RA− T-cell expansions induced by CMV did not influence RR, iii) Recovery of anti- CMV and also anti-adenovirus immunity and of naïve CD4+ T-cells was faster in the non-relapse group ( P = 0·008; 0·009 and 0·002 respectively). In contrast to adult acute myeloid leukaemia, CMV reactivation was associated with increased RR in this paediatric series. Accelerated overall immune recovery rather than CMV-driven immunity had a favourable impact on RR.
- Subjects
CYTOMEGALOVIRUSES; IMMUNITY; GRAFT versus host disease; LEUKEMIA in children; HEMATOPOIETIC stem cells; FOLLOW-up studies (Medicine)
- Publication
British Journal of Haematology, 2014, Vol 166, Issue 2, p229
- ISSN
0007-1048
- Publication type
Article
- DOI
10.1111/bjh.12875