TITLE

Virus infection in HLA-haploidentical hematopoietic stem cell transplantation: incidence in the context of immune recovery in two different transplantation settings

AUTHOR(S)
Tischer, Johanna; Engel, Nicole; Fritsch, Susanne; Prevalsek, Dusan; Hubmann, Max; Schulz, Christoph; Zoellner, Anna-K.; Bücklein, Veit; Reibke, Roland; Mumm, Friederike; Rieger, Christina; Hill, Wolfgang; Ledderose, Georg; Stemmler, Hans; Köhnke, Thomas; Jäger, Gundula; Kolb, Hans; Schmid, Christoph; Moosmann, Andreas; Hausmann, Andreas
PUB. DATE
October 2015
SOURCE
Annals of Hematology;Oct2015, Vol. 94 Issue 10, p1677
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
We retrospectively compared the incidence of virus infections and outcome in the context of immune reconstitution in two different HLA-haploidentical transplantation (haplo-HSCT) settings. The first was a combined T-cell-replete and T-cell-deplete approach using antithymocyte globulin (ATG) prior to transplantation in patients with hematological diseases (cTCR/TCD group, 28 patients; median age 31 years). The second was a T-cell-replete (TCR) approach using high-dose posttransplantation cyclophosphamide (TCR/PTCY group, 27 patients; median age 43 years). The incidence of herpesvirus infection was markedly lower in the TCR/PTCY (22 %) than in the cTCR/TCD group (93 %). Recovery of CD4+ T cells on day +100 was faster in the TCR/PTCY group. CMV reactivation was 30 % in the TCR/PTCY compared to 57 % in the cTCR/TCD group, and control with antiviral treatment was superior after TCR/PTCY transplantation (100 vs 50 % cTCR/TCD). Twenty-five percent of the patients in the cTCR/TCD group but no patient in the TCR/PTCY group developed PTLD. While 1-year OS was not different (TCR/PTCY 59 % vs cTCR/TCD 39 %; p = 0.28), virus infection-related mortality (VIRM) was significantly lower after TCR/PTCY transplantation (1-year VIRM, 0 % TCR/PTCY vs 29 % cTCR/TCD; p = 0.009). On day +100, predictors of better OS were lymphocytes >300/μl, CD3+ T cells >200/μl, and CD4+ T cells >150/μl, whereas the application of steroids >1 mg/kg was correlated with worse outcome. Our results suggest that by presumably preserving antiviral immunity and allowing fast immune recovery of CD4+ T cells, the TCR approach using posttransplantation cyclophosphamide is well suited to handle the important issue of herpesvirus infection after haplo-HSCT.
ACCESSION #
109251015

 

Related Articles

  • Immune Reconstitution Following Unmanipulated HLA-Mismatched/Haploidentical Transplantation Compared with HLA-Identical Sibling Transplantation. Chang, Ying-Jun; Zhao, Xiang-Yu; Huo, Ming-Rui; Xu, Lan-Ping; Liu, Dai-Hong; Liu, Kai-Yan; Huang, Xiao-Jun // Journal of Clinical Immunology;Apr2012, Vol. 32 Issue 2, p268 

    In this study, we prospectively investigated the immune reconstitution in patients with hematological malignancies after human leukocyte antigen (HLA)-mismatched/unmanipulated haploidentical transplantation (50 cases) and HLA-matched transplant (25 cases). Transplant-related mortality, relapse,...

  • Impact of lymphocyte and monocyte recovery on the outcomes of allogeneic hematopoietic SCT with fludarabine and melphalan conditioning. DeCook, L J; Thoma, M; Huneke, T; Johnson, N D; Wiegand, R A; Patnaik, M M; Litzow, M R; Hogan, W J; Porrata, L F; Holtan, S G // Bone Marrow Transplantation;May2013, Vol. 48 Issue 5, p708 

    We have recently shown that lymphocyte and monocyte recovery by day +100 are associated with survival post myeloablative allogeneic hematopoietic transplant for acute leukemia. We hypothesized that lymphocyte and monocyte recovery would have a similar impact on survival in the reduced intensity...

  • Non-myeloablative autologous haematopoietic stem cell transplantation expands regulatory cells and depletes IL-17 producing mucosal-associated invariant T cells in multiple sclerosis. Constantinescu, Cris // Current Medical Literature: Multiple Sclerosis;2013, Vol. 5 Issue 4, p107 

    The article presents a review of the study regarding the mechanisms of autologous hematopoietic stem cell transplantation (aHSCT) in patients with multiple sclerosis (MS). It provides details of the study that uses data from several centers where in patients have underwent nonmyeloablative aHSCT...

  • Immune reconstitution post allogeneic transplant and the impact of immune recovery on the risk of infection. Mehta, Rohtesh S.; Rezvani, Katayoun // Virulence;2016, Vol. 7 Issue 8, p901 

    Infection is the leading cause of non-relapse mortality after allogeneic haematopoietic cell transplantation (HCT). This occurs as a result of dysfunction to the host immune system from the preparative regimen used prior to HCT, combined with a delay in reconstitution of the donor-derived immune...

  • CMV-specific immune reconstitution following allogeneic stem cell transplantation. Blyth, Emily; Withers, Barbara; Clancy, Leighton; Gottlieb, David // Virulence;2016, Vol. 7 Issue 8, p967 

    Cytomegalovirus (CMV) remains a major contributor to morbidity and mortality following allogeneic haemopoietic stem cell transplant (HSCT) despite widespread use of viraemia monitoring and pre-emptive antiviral therapy. Uncontrolled viral replication occurs primarily in the first 100 d post...

  • Prophylaxis and treatment of GVHD: EBMT-ELN working group recommendations for a standardized practice. Ruutu, T; Gratwohl, A; de Witte, T; Afanasyev, B; Apperley, J; Bacigalupo, A; Dazzi, F; Dreger, P; Duarte, R; Finke, J; Garderet, L; Greinix, H; Holler, E; Kröger, N; Lawitschka, A; Mohty, M; Nagler, A; Passweg, J; Ringdén, O; Socié, G // Bone Marrow Transplantation;Feb2014, Vol. 49 Issue 2, p168 

    GVHD remains the major impediment to broader application of allogeneic haematopoietic SCT. It can be prevented completely, but at the expense of other complications, rejection, relapse or delayed immune reconstitution. No optimal prevention or treatment method has been defined. This is reflected...

  • HLA Class I Supertype Associations With Clinical Outcome of Secondary Dengue Virus Infections in Ethnic Thais. Stuehler, Claudia; Kuenzli, Esther; Jaeger, Veronika K.; Baettig, Veronika; Ferracin, Fabrizia; Rajacic, Zarko; Kaiser, Deborah; Bernardini, Claudia; Forrer, Pascal; Weisser, Maja; Elzi, Luigia; Battegay, Manuel; Halter, Joerg; Passweg, Jakob; Khanna, Nina // Journal of Infectious Diseases;9/15/2015, Vol. 212 Issue 6, p939 

    Background: Human leukocyte antigen (HLA) supertypes are groups of functionally related alleles that present structurally similar antigens to the immune system. Objectives: To analyze HLA class I supertype associations with clinical outcome in hospitalized Thai children with acute dengue...

  • Graves' Immune Reconstitution Inflammatory Syndrome in Childhood. Sinha, Akash; Abinun, Mario; Gennery, Andrew R.; Barge, Dawn; Slatter, Mary; Cheetham, Tim // Thyroid;Aug2013, Vol. 23 Issue 8, p1010 

    Background: The use of hematopoietic stem cell transplantations (HSCTs) as a curative therapy for life-threatening immunodeficiencies has had a profound impact on clinical outcomes. A subset of patients may experience immune reconstitution inflammatory syndrome (IRIS) post-transplant affecting...

  • Central nervous system immune reconstitution inflammatory syndrome (IRIS) after hematopoietic SCT. Airas, L.; Päivärinta, M.; Röyttä, M.; Karhu, J.; Kauppila, M.; Itälä-Remes, M.; Remes, K. // Bone Marrow Transplantation;Mar2010, Vol. 45 Issue 3, p593 

    The article presents a case study of 31-year-old man who was diagnosed with chronic myeloid leukemia (CML). He was treated with allogeneic hematopoietic stem cell transplantation (HSCT) and developed a severe form of central nervous system immune reconstitution inflammatory syndrome (CNS IRIS)....

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics