Wagner-Drouet, Eva and Teschner, Daniel and Wolschke, Christine and Janson, Dietlinde and Schaefer-Eckart, Kerstin and Gaertner, Johannes and Mielke, Stephan and Schreder, Martin and Kobbe, Guido and Kondakci, Mustafa and Hilgendorf, Inken and von Lilienfeld-Toal, Marie and Klein, Stefan and Heidenreich, Daniela and Kreil, Sebastian and Verbeek, Mareike and Grass, Sandra and Ditschkowski, Markus and Gromke, Tanja and Koch, Martina and Lindemann, Monika and Huenig, Thomas and Schmidt, Traudel and Rascle, Anne and Guldan, Harald and Barabas, Sascha and Deml, Ludwig and Wagner, Ralf and Wolff, Daniel (2021) Standardized monitoring of cytomegalovirus-specific immunity can improve risk stratification of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation. HAEMATOLOGICA, 106 (2). pp. 363-374. ISSN 0390-6078,
Full text not available from this repository. (Request a copy)Abstract
Recurrence of cytomegalovirus reactivation remains a major cause of morbidity and mortality following allogeneic hematopoietic stem cell transplantation. Monitoring cytomegalovirus-specific cellular immunity using a standardized assay might improve the risk stratification of patients. A prospective multicenter study was conducted in 175 intermediate- and high-risk allogeneic hematopoietic stem cell transplant recipients under preemptive antiviral therapy. Cytomegalovirus-specific cellular immunity was measured using a standardized interferon. enzyme-linked immunospot assay (T-Track (R) CMV). The primary aim was to evaluate the suitability of measuring cytomegalovirus-specific immunity after the end of treatment for a first cytomegalovirus reactivation to predict recurrent reactivation. Forty of 101 (39.6%) patients with a first cytomegalovirus reactivation experienced recurrent reactivations, mainly in the high-risk group (cytomegalovirus-seronegative donor/cytomegalovirus-seropositive recipient). The positive predictive value of T-Track (R) CMV (patients with a negative test after the first reactivation who experienced at least one recurrent reactivation) was 84.2% in high-risk patients. Kaplan-Meier analysis revealed a higher probability of recurrent cytomegalovirus reactivation in high-risk patients with a negative test after the first reactivation (hazard ratio 2.73; P=0.007). Interestingly, a post-hoc analysis considering T-Track (R) CMV measurements at day 100 after transplantation, a time point highly relevant for outpatient care, showed a positive predictive value of 90.0% in high-risk patients. Our results indicate that standardized cytomegalovirus-specific cellular immunity monitoring may allow improved risk stratification and management of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CD8(+) T-CELLS; IDENTIFY PATIENTS; QUANTIFERON-CMV; RECONSTITUTION; RECIPIENTS; INFECTION; DISEASE; CD4(+); RESPONSES; ASSAY; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Sep 2022 13:34 |
| Last Modified: | 09 Sep 2022 13:34 |
| URI: | https://pred.uni-regensburg.de/id/eprint/46988 |
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