CMV infection combined with acute GVHD associated with poor CD8+ T-cell immune reconstitution and poor prognosis post-HLA-matched allo-HSCT.

Abstract

Cytomegalovirus (CMV) infection and acute graft-versus-host disease (aGVHD) are two major complications that contribute to a poor prognosis after hematopoietic stem cell transplantation (HSCT). Superior early immune reconstitution (IR) is associated with improved survival after HSCT. However, when all three factors, CMV infection, aGVHD, and IR, are concomitantly considered, the effects of the triple events on HSCT are still unknown and should be studied further. Thus we enrolled 185 patients who were diagnosed as hematological malignancies and treated with HLA-matched sibling transplantation (MST) between January 2010 and December 2014, of whom 83 were positive for CMV infection and 82 had aGVHD. Results showed that patients with both aGVHD and CMV infection had significantly higher non-relapse mortality (NRM), lower overall survival (OS), and delayed CD8+ T-cell IR. Multivariate analyses showed that both aGVHD combined with CMV infection and delayed CD8+ T-cell IR were independent risk factors for prognosis post-MST. Recurrent CMV infections are associated with poor CD8+ T-cell reconstitution. However, superior IR could protect against the negative effects of aGVHD and CMV infection on the transplant outcomes.

• Authors: Ze-Ying Fan, Ting-Ting Han, Wei Zuo, Xiao-Su Zhao, Ying-Jun Chang, Meng Lv, Xiao-Dong Mo, Yu-Qian Sun, Yuan-Yuan Zhang, Yu Wang, Lan-Ping Xu, Xiao-Hui Zhang, Kai-Yan Liu, Xiao-Jun Huang, Xiang-Yu Zhao
• Journal: Clinical and experimental immunology (Clin Exp Immunol) Vol. 208 Issue 3 Pg. 332-339 (06 23 2022) ISSN: 1365-2249 [Electronic] England
• PMID: 35551362 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Immunology. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• CD8-Positive T-Lymphocytes
• Cytomegalovirus Infections
• Graft vs Host Disease
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Immune Reconstitution
• Prognosis
• Retrospective Studies
• Transplantation, Homologous