PMID- 21585633
OWN - NLM
STAT- MEDLINE
DCOM- 20111017
LR  - 20220321
IS  - 1399-3062 (Electronic)
IS  - 1398-2273 (Linking)
VI  - 13
IP  - 3
DP  - 2011 Jun
TI  - Tetramer monitoring to assess risk factors for recurrent cytomegalovirus 
      reactivation and reconstitution of antiviral immunity post allogeneic 
      hematopoietic stem cell transplantation.
PG  - 222-36
LID - 10.1111/j.1399-3062.2011.00626.x [doi]
AB  - BACKGROUND: Reactivation of cytomegalovirus (CMV) is a major cause of morbidity 
      after allogeneic hematopoietic stem cell transplantation (HSCT). In healthy 
      individuals, virus-specific T cells (CMV-CTL) control the reactivation of latent 
      CMV. The monitoring of virus-epitope-binding CD8(+) T cells using major 
      histocompatibility complex-I-peptide complexes (tetramers) has recently been 
      established, allowing assessment of the reconstitution of CMV-CTL post HSCT. 
      PATIENTS AND METHODS: In order to study immune reconstitution and reactivation 
      control through CMV-CTL, we regularly monitored all patients undergoing 
      allogeneic HSCT in our department for 2 years, who matched at least 1 of 6 
      commercially available tetramers for common human leukocyte antigen (HLA) types. 
      To verify risk factors for CMV reactivations in our cohorts, clinical 
      characteristics of all patients transplanted within the last 10 years were 
      included in statistical analyses determining the relative risk for single and 
      recurrent CMV reactivations. RESULTS: As expected, CMV serostatus, HLA match, and 
      donor source significantly influenced the risk of recurrent CMV reactivation. 
      Applying CMV-CTL tetramer monitoring for 2 years allowed the monitoring of 114 
      (85%) of 134 patients, by testing a set of tetramers representing 6 epitopes from 
      3 different CMV proteins. The presence of CMV-CTL before day + 50 and their 
      expansion post reactivation seem to protect against recurrent CMV reactivations. 
      The mean number of CMV-CTL by day +100 was >5-fold higher in the recipient 
      CMV-positive/donor-positive (R +/D +) group (91/muL) compared with the R +/ D- 
      (13/muL) and the R -/D +(2/muL) group. Seventy-nine percent of patients from the R 
      +/D + setting recovered >10 CMV-CTL per muL by day + 100, while almost 50% of the 
      other groups failed to mount a CMV-specific response by that time (R +/D -: 58%; 
      R -/D +: 43%). CONCLUSION: Tetramer monitoring can help to predict (recurrent) 
      CMV reactivation and is a useful approach to monitor individual patients with 
      increased risk for recurrent reactivation post HSCT; thus, it could help to 
      identify patients in need of adoptive transfer of CMV-CTL or to optimize the use 
      of antiviral drugs.
CI  - (c) 2011 John Wiley & Sons A/S.
FAU - Borchers, S
AU  - Borchers S
AD  - Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, 
      Hannover Medical School, Hannover, Germany.
FAU - Luther, S
AU  - Luther S
FAU - Lips, U
AU  - Lips U
FAU - Hahn, N
AU  - Hahn N
FAU - Kontsendorn, J
AU  - Kontsendorn J
FAU - Stadler, M
AU  - Stadler M
FAU - Buchholz, S
AU  - Buchholz S
FAU - Diedrich, H
AU  - Diedrich H
FAU - Eder, M
AU  - Eder M
FAU - Koehl, U
AU  - Koehl U
FAU - Ganser, A
AU  - Ganser A
FAU - Mischak-Weissinger, E
AU  - Mischak-Weissinger E
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
DEP - 20110518
PL  - Denmark
TA  - Transpl Infect Dis
JT  - Transplant infectious disease : an official journal of the Transplantation 
      Society
JID - 100883688
RN  - 0 (Histocompatibility Antigens Class I)
RN  - 0 (Multiprotein Complexes)
RN  - 0 (Peptides)
SB  - IM
MH  - Adult
MH  - CD8-Positive T-Lymphocytes/immunology
MH  - Cohort Studies
MH  - Cytomegalovirus/immunology/*physiology
MH  - Cytomegalovirus Infections/diagnosis/immunology/virology
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Histocompatibility Antigens Class I/*immunology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*immunology
MH  - Male
MH  - Middle Aged
MH  - Multiprotein Complexes/*immunology
MH  - Peptides/*immunology
MH  - Recurrence
MH  - Risk Factors
MH  - Transplantation, Homologous/adverse effects
MH  - Virus Activation/*physiology
EDAT- 2011/05/19 06:00
MHDA- 2011/10/18 06:00
CRDT- 2011/05/19 06:00
PHST- 2011/05/19 06:00 [entrez]
PHST- 2011/05/19 06:00 [pubmed]
PHST- 2011/10/18 06:00 [medline]
AID - 10.1111/j.1399-3062.2011.00626.x [doi]
PST - ppublish
SO  - Transpl Infect Dis. 2011 Jun;13(3):222-36. doi: 10.1111/j.1399-3062.2011.00626.x. 
      Epub 2011 May 18.