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- Title
Impact of cytomegalovirus immunodominant HLA‐I donor–recipient matching on the incidence and features of virus DNAemia and virus‐specific T‐cell immune reconstitution in unmanipulated haploidentical hematopoietic stem cell transplantation
- Authors
Huntley, Dixie; Giménez, Estela; Vázquez, Lourdes; Pascual, María Jesús; Amat, Paula; Remigia, María José; Hernández‐Boluda, Juan Carlos; García, Magdalena; Gago, Beatriz; Torres, Ignacio; de la Asunción, Carlos Solano; Hernani, Rafael; Pérez, Ariadna; Albert, Eliseo; Piñana, José Luis; Solano, Carlos; Navarro, David
- Abstract
Background: We investigated whether donor‐recipient mismatch involving one or more cytomegalovirus (CMV) immunodominant (ID) human leukocyte antigen (HLA)‐I alleles may impact on the degree of CMV pp65/immediate‐early 1 (IE‐1) T‐cell reconstitution and the incidence of CMV DNAemia in patients undergoing unmanipulated haploidentical hematopoietic stem cell transplantation with high‐dose posttransplant cyclophosphamide (PT/Cy‐haplo). Methods: Multicenter observational study including 106 consecutive adult PT/Cy‐haplo patients (34 CMV ID HLA‐I matched and 72 mismatched). A real‐time PCR was used for plasma CMV DNA load monitoring. Enumeration of CMV‐specific (pp65/IE‐1) interferon (IFN)‐γ‐producing T cells from several patients was performed by flow cytometry by days +30, +60, +90 and +180 after transplantation. Results: The cumulative incidence of CMV DNAemia, clinically significant CMV DNAemia episodes (cs‐CMVi), and recurrent CMV DNAemia was comparable across CMV ID HLA‐I matched and mismatched patients (71.8% vs. 80.9%, p =.95; 40.7% vs. 44.2%, p =.85; 16.4% vs. 28.1%; p =.43, respectively). The percentage of patients exhibiting detectable CMV‐specific IFN‐γ‐producing T‐cell responses (either CD8+ or CD4+) was similar across groups; nevertheless, significantly higher CMV‐specific CD8+ T‐cell counts were enumerated in the CMV ID HLA‐I matched compared to mismatched patients by day +60 (p =.04) and +180 (p =.016) after transplantation. Conclusion: CMV ID HLA‐I matching may impact on the magnitude of CMV‐pp65/IE‐1‐specific CD8+ T‐cell reconstitution; yet, this effect seemed not to have an impact on the incidence of initial, recurrent CMV DNAemia, or cs‐CMVi.
- Subjects
HEMATOPOIETIC stem cell transplantation; BK virus; IMMUNE reconstitution inflammatory syndrome; T cells; HLA histocompatibility antigens; CYTOMEGALOVIRUSES
- Publication
Transplant Infectious Disease, 2023, Vol 25, Issue 3, p1
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/tid.14065