Quantiferon CMV assay in allogenic stem cell transplant patients

Bono, Patrizia; Orlandi, Alessia; Zoccoli, Antonella; Salvatore, Alberto; Annaloro, C.; Tagliaferri, Elena; Lunghi, G.

doi:10.1016/j.jcv.2016.03.026

Cited by 10 publications

(15 citation statements)

References 3 publications

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“…The minimal number of CD3+ T cells required for robust results has not been established yet, although some laboratories have established the minimum cutoff of 100 T lymphocytes/cmm. Numerous studies have assessed CMI assays to determine the risk of CMV infection/disease after allo‐HSCT (Table ) . IGRAs were performed weekly or monthly after engraftment until 100 days or 12 months from transplant .…”

Section: Resultsmentioning

confidence: 99%

Assessment and prevention of cytomegalovirus infection in allogeneic hematopoietic stem cell transplant and in solid organ transplant: A multidisciplinary consensus conference by the Italian GITMO, SITO, and AMCLI societies

Girmenia

Lazzarotto

Bonifazi

et al. 2019

Clinical Transplantation

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Cytomegalovirus (CMV) remains a major cause of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (allo-HSCT) and solid organ transplantation (SOT) recipients. In view of the uncertainties on the assessment and prevention of CMV infection in both transplant procedures, three Italian scientific societies for HSCT and SOT and for Clinical Microbiology appointed a panel of experts to compose a framework of recommendations. Recommendations were derived from a comprehensive analysis of the scientific literature and from a multidisciplinary consensus conference process. The lack of adequate clinical trials focused on certain

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Section: Resultsmentioning

confidence: 99%

Assessment and prevention of cytomegalovirus infection in allogeneic hematopoietic stem cell transplant and in solid organ transplant: A multidisciplinary consensus conference by the Italian GITMO, SITO, and AMCLI societies

Girmenia

Lazzarotto

Bonifazi

et al. 2019

Clinical Transplantation

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“…Great emphasis has been placed on the frequency of IFN-g-producing CD8 T cells for the purposes of immune monitoring in HCT recipients [53,54]. However, single cytokine measurements are limited as predictors of immunologic and clinical outcomes after HCT [18,55]. Thus, in the present study, we incorporated monitoring of CD137 expression into our longitudinal assessment of memory surface markers.…”

Section: Discussionmentioning

confidence: 99%

Rapid Acquisition of Cytomegalovirus-Specific T Cells with a Differentiated Phenotype, in Nonviremic Hematopoietic Stem Transplant Recipients Vaccinated with CMVPepVax

Rosa

Longmate

Lingaraju

et al. 2019

Biology of Blood and Marrow Transplantation

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A B S T R A C T Early cytomegalovirus (CMV) reactivation remains a significant cause of morbidity and mortality in allogeneic hematopoietic cell transplant (HCT) recipients. CMVPepVax is an investigational peptide vaccine designed to control CMV infection in HCT recipients seropositive for CMV by stimulating the expansion of T cell subsets that target the CMV tegument protein pp65. In a randomized Phase Ib pilot trial (ClinicalTrials.gov NCT01588015), two injections of CMVPepVax (at days 28 and 56 post-HCT) demonstrated safety, immunogenicity, increased relapse-free survival, and reduced CMV reactivation and use of antivirals. In the present study, we assessed the phenotypes and time courses of the pp65-specific CD8 T cell subsets that expanded in response to CMVPepVax vaccination. The functionality and antiviral role of CMV-specific T cells have been linked to immune reconstitution profiles characterized predominantly by differentiated effector memory T (TEM) subsets that have lost membrane expression of the costimulatory molecule CD28 and often reexpress the RA isoform of CD45 (TEMRA). Major histocompatibility complex class I pp65 495-503 multimers, as well as CD28 and CD45 memory markers, were used to detect immune reconstitution in blood specimens from HCT recipients enrolled in the Phase Ib clinical trial. Specimens from the 10 (out of 18) vaccinated patients who had adequate (.2%) multimer binding to allow for memory analysis showed highly differentiated TEM and TEMRA phenotypes for pp65 495-503 -specific CD8 T cells during the first 100 days post-transplantation. In particular, by day 70, during the period of highest risk for CMV reactivation, combined TEM and TEMRA phenotypes constituted a median of 90% of pp65 495-503 -specific CD8 T cells in these vaccinated patients. CMV viremia was not detectable in the patients who received CMVPepVax, although their pp65 495-503 -specific CD8 T cell profiles were strikingly similar to those observed in viremic patients who did not receive the vaccine. Collectively, our findings indicate that in the absence of clinically relevant viremia, CMVPep-Vax reconstituted significant levels of differentiated pp65 495-503 -specific CD8 TEMs early post-HCT. Our data indicate that the rapid reconstitution of CMV-specific T cells with marked levels of effector phenotypes may have been key to the favorable outcomes of the CMVPepVax clinical trial.

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“…However, the minimal number of CD3 + T cells required for robust results has not been established yet. Numerous studies have assessed assays of immune function to determine risk of CMV disease after HSCT (Table ) . IGRAs were performed regularly (ie, weekly or monthly) after engraftment for a variable period (in the first 100 days or until 12 months from transplant) .…”

Section: Immunological Monitoringmentioning

confidence: 99%

“…Numerous studies have assessed assays of immune function to determine risk of CMV disease after HSCT (Table ) . IGRAs were performed regularly (ie, weekly or monthly) after engraftment for a variable period (in the first 100 days or until 12 months from transplant) . CMV‐specific immunity reconstitution, as measured by IGRAs, was associated to lower incidence of CMV infection and disease, lower rate of CMV infection recurrence, higher spontaneous viral clearance, lower peak viral loads, and shorter length of viral treatment .…”

Section: Immunological Monitoringmentioning

confidence: 99%

“…IGRAs were performed regularly (ie, weekly or monthly) after engraftment for a variable period (in the first 100 days or until 12 months from transplant) . CMV‐specific immunity reconstitution, as measured by IGRAs, was associated to lower incidence of CMV infection and disease, lower rate of CMV infection recurrence, higher spontaneous viral clearance, lower peak viral loads, and shorter length of viral treatment . According to these experiences, a IGRA may be performed after engraftment monthly until 3‐12 months from transplant according to the viral infection risk of the patients and/or after CMV reactivation as a guide to the viral infection management.…”

Section: Immunological Monitoringmentioning

confidence: 99%

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Advances inCMVinfection prevention and treatment after allo‐HSCT

Girmenia

2019

Adv Cell Gene Ther

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Cytomegalovirus (CMV) remains a major cause of morbidity and mortality in allogeneic hematopoietic stem cell transplant (HSCT) recipients. Despite this knowledge, a number of CMV-related diagnostic and therapeutic issues remain critical. No uniform guidance exists for the best strategy to monitor and prevent CMV infection and disease. In particular, we lack standard threshold values for assessing the CMV DNAemia in the monitoring of CMV infection; there is no consensus in the adoption of immunoglobulin therapy and adoptive transfer of HSCT donor-derived CMV-specific T cells. Furthermore, antiviral drugs used in the preemptive therapy are characterized by high levels of toxicity. Of interest, recent availability of new drugs will probably modify the antiviral strategy in a large proportion of patients. The uncertainty in the management of CMV infections is further complicated by the continuous evolution in the transplantation strategies and the consequent infectious risk. This paper will focus on challenging issues in the monitoring, prevention, and treatment of CMV infections in allo-HSCT populations. Assessment of pretransplant CMV status, immunological monitoring after transplant, and CMV disease prevention and therapy strategies will be discussed. K E Y W O R D Scytomegalovirus, diagnosis, hematopoietic stem cell transplant, prophylaxis

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Quantiferon CMV assay in allogenic stem cell transplant patients

Cited by 10 publications

References 3 publications

Assessment and prevention of cytomegalovirus infection in allogeneic hematopoietic stem cell transplant and in solid organ transplant: A multidisciplinary consensus conference by the Italian GITMO, SITO, and AMCLI societies

Assessment and prevention of cytomegalovirus infection in allogeneic hematopoietic stem cell transplant and in solid organ transplant: A multidisciplinary consensus conference by the Italian GITMO, SITO, and AMCLI societies

Rapid Acquisition of Cytomegalovirus-Specific T Cells with a Differentiated Phenotype, in Nonviremic Hematopoietic Stem Transplant Recipients Vaccinated with CMVPepVax

Advances inCMVinfection prevention and treatment after allo‐HSCT

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