Clinical Assessment of Anti-Viral CD8+ T Cell Immune Monitoring Using QuantiFERON-CMV® Assay to Identify High Risk Allogeneic Hematopoietic Stem Cell Transplant Patients with CMV Infection Complications

Tey, Siok-Keen, Kennedy, Glen A., Cromer, Deborah, Davenport, Miles P., Walker, Susan, Jones, Linda I., Crough, Tania, Durrant, Simon T., Morton, James A., Butler, Jason P., Misra, Ashish K., Hill, Geoffrey R. and Khanna, Rajiv (2013) Clinical Assessment of Anti-Viral CD8+ T Cell Immune Monitoring Using QuantiFERON-CMV® Assay to Identify High Risk Allogeneic Hematopoietic Stem Cell Transplant Patients with CMV Infection Complications. PLoS ONE, 8 10: . doi:10.1371/journal.pone.0074744

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Author Tey, Siok-Keen
Kennedy, Glen A.
Cromer, Deborah
Davenport, Miles P.
Walker, Susan
Jones, Linda I.
Crough, Tania
Durrant, Simon T.
Morton, James A.
Butler, Jason P.
Misra, Ashish K.
Hill, Geoffrey R.
Khanna, Rajiv
Title Clinical Assessment of Anti-Viral CD8+ T Cell Immune Monitoring Using QuantiFERON-CMV® Assay to Identify High Risk Allogeneic Hematopoietic Stem Cell Transplant Patients with CMV Infection Complications
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2013-10-11
Year available 2013
Sub-type Article (original research)
DOI 10.1371/journal.pone.0074744
Open Access Status DOI
Volume 8
Issue 10
Total pages 7
Place of publication San Francisco, CA, U.S.A.
Publisher Public Library of Science (PLoS)
Language eng
Subject 1100 Agricultural and Biological Sciences
1300 Biochemistry, Genetics and Molecular Biology
2700 Medicine
Abstract The reconstitution of anti-viral cellular immunity following hematopoietic stem cell transplantation (HSCT) is crucial in preventing cytomegalovirus (CMV)-associated complications. Thus immunological monitoring has emerged as an important tool to better target pre-emptive anti-viral therapies. However, traditional laboratory-based assays are too cumbersome and complicated to implement in a clinical setting. Here we conducted a prospective study of a new whole blood assay (referred to as QuantiFERON-CMV®) to determine the clinical utility of measuring CMV-specific CD8+ T-cell responses as a prognostic tool. Forty-one evaluable allogeneic HSCT recipients underwent weekly immunological monitoring from day 21 post-transplant and of these 21 (51.2%) showed CMV reactivation and 29 (70.7%) developed acute graft-versus-host disease (GvHD). Patients with acute GvHD (grade≥2) within 6 weeks of transplant showed delayed reconstitution of CMV-specific T-cell immunity (p = 0.013) and a higher risk of CMV viremia (p = 0.026). The median time to stable CMV-specific immune reconstitution was 59 days and the incidence of CMV reactivation was lower in patients who developed this than those who did not (27% versus 65%; p = 0.031). Furthermore, a failure to reconstitute CMV-specific immunity soon after the onset of CMV viraemia was associated with higher peak viral loads (5685 copies/ml versus 875 copies/ml; p = 0.002). Hence, QuantiFERON-CMV® testing in the week following CMV viremia can be useful in identifying HSCT recipients at risk of complicated reactivation.
Keyword Multidisciplinary Sciences
Science & Technology - Other Topics
MULTIDISCIPLINARY SCIENCES
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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