Possible Impact of Cytomegalovirus-Specific CD8 T Cells on Immune Reconstitution and Conversion to Complete Donor Chimerism after Allogeneic Stem Cell Transplantation.

Biol Blood Marrow Transplant 2017 Jul 23;23(7):1046-1053. Epub 2017 Mar 23.

Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany. Electronic address:

Complete donor chimerism is strongly associated with complete remission after allogeneic stem cell transplantation (allo-SCT) in patients with hematologic malignancies. Donor-derived allo-immune responses eliminate the residual host hematopoiesis and thereby mediate the conversion to complete donor chimerism. Recently, cytomegalovirus (CMV) reactivation was described to enhance overall T cell reconstitution, to increase graft-versus-host disease incidence, and to reduce the leukemia relapse risk. However, the link between CMV and allo-immune responses is still unclear. Here, we studied the relationship between CMV-specific immunity, overall T cell reconstitution, and residual host chimerism in 106 CMV-seropositive patients transplanted after reduced-intensity conditioning including antithymocyte globulin. In accordance with previous reports, the recovery of CMV-specific cytotoxic T cells (CMV-CTLs) was more frequent in CMV-seropositive recipients (R) transplanted from CMV-seropositive than from seronegative donors (D). However, once CMV-CTLs were detectable, the reconstitution of CMV-specific CTLs was comparable in CMV R+/D- and R+/D+ patients. CD3 and CD8 T cell reconstitution was significantly faster in patients with CMV-CTLs than in patients without CMV-CTLs both in the CMV R+/D- and R+/D+ setting. Moreover, CMV-CTL numbers correlated with CD3 and CD8 T cell numbers in both settings. Finally, presence of CMV-CTLs was associated with low host chimerism levels 3 months after allo-SCT. In conclusion, our data provide a first indication that CMV-CTLs in CMV-seropositive patients might trigger the reconstitution of T cells and allo-immune responses reflected by the conversion to complete donor chimerism.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.bbmt.2017.03.027DOI Listing
July 2017
81 Reads

Publication Analysis

Top Keywords

complete donor
16
donor chimerism
16
allo-immune responses
12
conversion complete
12
cell reconstitution
12
cell transplantation
8
allogeneic stem
8
patients cmv-ctls
8
stem cell
8
cd3 cd8
8
host chimerism
8
cmv-seropositive patients
8
residual host
8
cmv r+/d-
8
r+/d- r+/d+
8
cd8 cell
8
cmv-ctls
6
reconstitution
6
chimerism
6
cell
6

Similar Publications