RSV infection results in a low overall attributable mortality after allo-HSCT, but progression of the infection to LRTI is associated with increased risk for death. Late respiratory dysfunction is more common among patients, experienced RSV infection compared with controls.

Seasonal vaccination against influenza boosts the cellular immune response both in SCT patients and healthy controls. The protective effect is lower in the patients in general and especially on those, vaccinated early after SCT.

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Patients experience cytomegalovirus (CMV) reactivation after stem cell transplantation (SCT) and need repeated courses of pre-emptive therapy. Analysis of CMV-specific immunity might help to assess the need for antiviral therapy. Forty-eight patients were studied during the first 3 months after SCT. Peripheral blood lymphocytes were stimulated by CMV antigen, and interferon (INF)-c production by CD3 þ and CD4 þ T cells was analysed.Results were correlated to transplant factors and CMV disease. Patients with INF-c production by CD3 þ cells at 4 weeks after SCT had lower peak viral loads than patients with no such production (P ¼ 0.03). There was a similar tendency as regards CD4 þ cells (P ¼ 0.09). Patients who underwent reduced-intensity conditioning (RIC) more frequently had CD3 þ (48%) and CD4 þ immunity (56%) 4 weeks after SCT compared with patients who received myeloablative conditioning (CD3 þ 25%; CD4 þ 35%). There was no effect of stem cell source, donor type or acute graft-versus-host disease. Three of 48 patients developed CMV disease and none of them had detectable INF-c production. CMV-specific Tcell response is associated with a lower rate of CMV replication. RIC results in improved T-cell reconstitution. Recovery of CMV-specific immunity might be delayed in patients with CMV disease. These observations suggest that detection of CMV-specific T-cells is useful in assessing the immunity against CMV.