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Standardized monito...
Standardized monitoring of cytomegalovirus-specific immunity can improve risk stratification of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation
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Wagner-Drouet, E (author)
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Teschner, D (author)
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Wolschke, C (author)
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Janson, D (author)
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Schafer-Eckart, K (author)
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Gartner, J (author)
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- Mielke, S (author)
- Karolinska Institutet
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Schreder, M (author)
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Kobbe, G (author)
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Kondakci, M (author)
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Hilgendorf, I (author)
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von Lilienfeld-Toal, M (author)
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Klein, S (author)
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Heidenreich, D (author)
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Kreil, S (author)
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Verbeek, M (author)
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Grass, S (author)
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Ditschkowski, M (author)
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Gromke, T (author)
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Koch, M (author)
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Lindemann, M (author)
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Hunig, T (author)
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Schmidt, T (author)
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Rascle, A (author)
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Guldan, H (author)
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Barabas, S (author)
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Deml, L (author)
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Wagner, R (author)
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Wolff, D (author)
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(creator_code:org_t)
- 2019-12-26
- 2021
- English.
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In: Haematologica. - : Ferrata Storti Foundation (Haematologica). - 1592-8721 .- 0390-6078. ; 106:2, s. 363-374
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https://doi.org/10.3...
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Abstract
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- 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 IFN-γ ELISpot assay (T-Track® CMV). Primary aim was to evaluate the suitability of measuring cytomegalovirus-specific immunity after end of treatment for a first cytomegalovirus reactivation to predict recurrent reactivation. 40/101 (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® CMV (patients with a negative test after the first reactivation 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® CMV measurements at day 100 post-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. This study was registered at www.clinicaltrials.gov as #NCT02156479.
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- ref (subject category)
- art (subject category)
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- By the author/editor
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Wagner-Drouet, E
-
Teschner, D
-
Wolschke, C
-
Janson, D
-
Schafer-Eckart, ...
-
Gartner, J
-
show more...
-
Mielke, S
-
Schreder, M
-
Kobbe, G
-
Kondakci, M
-
Hilgendorf, I
-
von Lilienfeld-T ...
-
Klein, S
-
Heidenreich, D
-
Kreil, S
-
Verbeek, M
-
Grass, S
-
Ditschkowski, M
-
Gromke, T
-
Koch, M
-
Lindemann, M
-
Hunig, T
-
Schmidt, T
-
Rascle, A
-
Guldan, H
-
Barabas, S
-
Deml, L
-
Wagner, R
-
Wolff, D
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show less...
- Articles in the publication
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Haematologica
- By the university
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Karolinska Institutet