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Randomized Controlled Trial
. 2012 Jan;18(1):66-75.
doi: 10.1016/j.bbmt.2011.05.010. Epub 2011 May 20.

VSports app下载 - Cytomegalovirus viral load and virus-specific immune reconstitution after peripheral blood stem cell versus bone marrow transplantation

Abraham Guerrero  1 , Stanley R Riddell, Jan Storek, Terry Stevens-Ayers, Barry Storer, John A Zaia, Stephen Forman, Robert S Negrin, Thomas Chauncey, William Bensinger, Michael Boeckh
Affiliations
Randomized Controlled Trial

V体育平台登录 - Cytomegalovirus viral load and virus-specific immune reconstitution after peripheral blood stem cell versus bone marrow transplantation

Abraham Guerrero et al. Biol Blood Marrow Transplant. 2012 Jan.

Abstract

Peripheral blood stem cell (PBSC) products contain more T cells and monocytes when compared with bone marrow (BM), leading to fewer bacterial and fungal infections. Cytomegelovirus (CMV) viral load and disease as well as CMV-specific immune reconstitution were compared in patients enrolled in a randomized trial comparing PSBC and BM transplantation. There was a higher rate of CMV infection and disease during the first 100 days after transplantation among PBSC recipients (any antigenemia/DNAemia: PBSC, 63% vs BM, 42%, P = . 04; CMV disease: PBSC, 17% vs BM, 4%, P = . 03). By 2 years, CMV disease rates were similar. The early increase in CMV events correlated temporarily with lower CMV-specific CD4(+) T helper and CD8(+) cytotoxic T lymphocyte function at 30 days after transplantation in PBSC recipients VSports手机版. By 3 months after transplantation and thereafter, CMV-specific immune responses were similar between BM and PBSC recipients. In conclusion, higher CMV infection and disease rates occurred in PBSC transplant recipients early after transplantation. These differences may be because of a transient delay in CMV-specific immune reconstitution following PBSC transplantation. .

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Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. Differences in CMV infection and disease between BM and PBSC recipients
Time to positive antigenemia or PCR positivity at any level (A), antigenemia > 100 positive cells per slide or CMV DNA>100,000 copies per mL plasma (B) and CMV disease (C) among CMV seropositive recipients (BM n= 50, PBSC n=46).
Figure 2
Figure 2. Effect of G-CSF on donor peripheral blood mononuclear cells (PBMC) and stem cell (SC) product
Figure (A) represents the number of CMV-specific CD4+ T helper cells in donor PBMC and the stem cell product, pre and post G-CSF treatment (n=12). P value is from the Wilcoxon matched pairs test.
Figure 3
Figure 3. Differences in CMV-specific T cell immune reconstitution between BM and PBSC recipients
Figure (A) represents the proportion of patients with CMV-specific cell lysis greater than 10% between BM and PBSC recipients at day 30 (BM n= 8, PBSC n= 8), 80 (BM n= 9, PBSC n= 8), 180 (BM n= 6, PBSC n= 7) and 365 (BM n= 6, PBSC n= 4) post-transplant. Figure (B) represents the proportion of patients with ≥ 33 CMV-specific CD4+ T cells per 106 PBMC as determined by limiting dilution assay at day 30, 80, 180 and 365 (BM n= 22, PBSC n= 22) post-transplant.
Figure 4
Figure 4. Differences in polyfunctional CMV-specific CD8+ T cells between BM and PBSC recipients
Figures (A & B) represent the absolute number of CD8+ T cells in BM (n=7†) and PBSC (n=6†) recipients positive for CD107a, IFNγ, MIP-1β and TNFα at d30 and d80 post transplantation. Figures (C & D) represent the absolute proportion of polyfunctional CMV-specific CD8+ T cells within BM and PBSC recipients at day 30 and 80. Figures (E & F) represent the MFI of IFNγ based on the degree of decreasing polyfunctionality of CMV-specific CD8+ T cells by the loss of one marker (CD107a, MIP-1β and TNFα). Polyfunctional T cells grouped by T cells positive for 1, 2, 3, or 4 of the markers based on the 16 possible combinations according to SPICE. P value is a result of the student's t test. Bars represent the mean value within each group and error bars are the standard error of the mean.
Figure 5
Figure 5. Comparison of CMV-specific polyfunctional CD8+ T cells between patients with no antigenemia and those with antigenemia
Figure (A) represents the number of polyfunctional T cells per L at day 30 in patients with no (n=5†) and any subsequent antigenemia (n=7†) at day 30 regardless of stem cell source. Figure (B) represents the number of CMV-specific CD4 T cells per L (by LDA) at day 30 in patients without (n=20†) and any subsequent antigenemia (n=11†) †Includes patients that were eligible for randomization but did not participate in the randomized trial. Bars represent the mean value within each group and error bars are the standard error of the mean.
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References

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