Toward Functional Immune Monitoring in Allogeneic Stem Cell Transplant Recipients.
Functional immune reconstitution
Viral infections
Journal
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
ISSN: 1523-6536
Titre abrégé: Biol Blood Marrow Transplant
Pays: United States
ID NLM: 9600628
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
22
08
2019
revised:
06
01
2020
accepted:
06
01
2020
pubmed:
14
1
2020
medline:
24
6
2021
entrez:
14
1
2020
Statut:
ppublish
Résumé
Serious viral infections, due to delayed immune reconstitution, are a leading cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). Thus, many transplant centers prospectively track cellular immune recovery by evaluating absolute cell numbers and the phenotypic profile of reconstituting T cell subsets to identify individuals who are at highest risk of infection. Conventional assessments, however, fail to measure either the antigen specificity or functional capacity of reconstituting cells-both factors that correlate with endogenous antiviral protection. In this pilot study, we sought to address this limitation by prospectively investigating the tempo of endogenous immune reconstitution in a cohort of 23 pediatric HSCT patients using both quantitative (flow cytometry) and qualitative (IFNγ ELISpot) measures, which we correlated with either the presence or absence of infections associated with cytomegalovirus, adenovirus, Epstein-Barr virus, BK virus, human herpes virus 6, respiratory syncytial virus, parainfluenza, influenza, and human metapneumovirus. We present data spanning 12 months post-transplant demonstrating the influence of conditioning on immune recovery and highlighting the differential impact of active viral replication on the quantity and quality of reconstituting cells. Judicious use of standard (phenotypic) and novel (functional) monitoring strategies can help guide the clinical care and personalized management of allogenic HSCT recipients with infections.
Identifiants
pubmed: 31927102
pii: S1083-8791(20)30015-X
doi: 10.1016/j.bbmt.2020.01.005
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
911-919Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Références
Bone Marrow Transplant. 2005 Nov;36(9):757-69
pubmed: 16151426
Blood. 2016 Jun 30;127(26):3331-40
pubmed: 27207801
Blood. 2014 Jul 17;124(3):334-43
pubmed: 24914138
J Clin Oncol. 2017 Nov 1;35(31):3547-3557
pubmed: 28783452
Bone Marrow Transplant. 2011 Aug;46(8):1089-98
pubmed: 21057553
Bone Marrow Transplant. 2007 Mar;39(5):269-78
pubmed: 17311085
PLoS One. 2013 Oct 11;8(10):e74744
pubmed: 24146744
Biol Blood Marrow Transplant. 2014 Apr;20(4):507-17
pubmed: 24406505
Virulence. 2016 Nov 16;7(8):901-916
pubmed: 27385018
Pediatr Transplant. 2018 Mar;22(2):
pubmed: 29297965
Biol Blood Marrow Transplant. 2013 Feb;19(2):305-13
pubmed: 23092812
N Engl J Med. 2017 Dec 21;377(25):2433-2444
pubmed: 29211658
Biol Blood Marrow Transplant. 2010 Oct;16(10):1428-35
pubmed: 20399877
Transpl Infect Dis. 2019 Aug;21(4):e13095
pubmed: 30993823
Transplantation. 2012 Mar 15;93(5):536-42
pubmed: 22314338
J Infect Dis. 2016 Jun 1;213(11):1701-7
pubmed: 26908740
Hematol Oncol Clin North Am. 2011 Feb;25(1):101-16
pubmed: 21236393
Biol Blood Marrow Transplant. 2009 Oct;15(10):1143-238
pubmed: 19747629
Bone Marrow Transplant. 2008 Jan;41(1):55-62
pubmed: 17934532
Curr Infect Dis Rep. 2018 Mar 14;20(4):4
pubmed: 29542023
Bone Marrow Transplant. 2013 Jun;48(6):803-8
pubmed: 23178547
Blood. 2012 Mar 1;119(9):1972-80
pubmed: 22210876
Blood Adv. 2019 Sep 10;3(17):2571-2580
pubmed: 31481503
Blood Adv. 2018 Apr 24;2(8):909-922
pubmed: 29678809