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  • Wagner-Drouet, E (author)

Standardized monitoring of cytomegalovirus-specific immunity can improve risk stratification of recurrent cytomegalovirus reactivation after hematopoietic stem cell transplantation

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2019-12-26
  • Ferrata Storti Foundation (Haematologica),2021

Numbers

  • LIBRIS-ID:oai:prod.swepub.kib.ki.se:146047092
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:146047092URI
  • https://doi.org/10.3324/haematol.2019.229252DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

Added entries (persons, corporate bodies, meetings, titles ...)

  • Teschner, D (author)
  • Wolschke, C (author)
  • Janson, D (author)
  • Schafer-Eckart, K (author)
  • Gartner, J (author)
  • Mielke, SKarolinska Institutet (author)
  • Schreder, M (author)
  • Kobbe, G (author)
  • Kondakci, M (author)
  • Hilgendorf, I (author)
  • von Lilienfeld-Toal, M (author)
  • Klein, S (author)
  • Heidenreich, D (author)
  • Kreil, S (author)
  • Verbeek, M (author)
  • Grass, S (author)
  • Ditschkowski, M (author)
  • Gromke, T (author)
  • Koch, M (author)
  • Lindemann, M (author)
  • Hunig, T (author)
  • Schmidt, T (author)
  • Rascle, A (author)
  • Guldan, H (author)
  • Barabas, S (author)
  • Deml, L (author)
  • Wagner, R (author)
  • Wolff, D (author)
  • Karolinska Institutet (creator_code:org_t)

Related titles

  • In:Haematologica: Ferrata Storti Foundation (Haematologica)106:2, s. 363-3741592-87210390-6078

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