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Pretransplantation CMV-specific T cells protect recipients of T-cell-depleted grafts against CMV-related complications

Degermann, Sylvie
Arlettaz, Lionel
Vischer, Solange
Walter, Steffen
Heemskerk, M. H.
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Published in Blood. 2006, vol. 107, no. 1, p. 389-396
Abstract We have studied cytomegalovirus (CMV) immunity in 17 CMV-positive recipients of T-cell-depleted or T-cell-replete grafts. In recipients of T-cell-replete grafts, the patient's CMV-specific T-cell response was completely ablated. Because primary anti-CMV responses were rare during the first year, immunity depended essentially on the transfer of donor CMV-specific T cells and, therefore, on the CMV positivity of the donor. In the recipients of T-cell-depleted grafts, CMV-specific cytotoxic T cells were of recipient origin in 2 patients who underwent transplantation with CMV-negative donors and in 3 of 8 patients who underwent transplantation with CMV-positive donors, and they were of mixed or donor origin in the other 5 patients studied. Recipient CMV-specific T cells responded vigorously to antigen ex vivo and persisted for several years without replenishment by donor cells. Furthermore, they appeared to have a protective effect because CMV-related complications were absent in the patients with CMV-specific T cells of recipient origin. Clinical outcomes of a cohort of 91 patients corroborated the experimental results. Patients with recipient T cells in their blood were protected regardless of the donor immune status. Hence, when a T-cell depletion protocol is used that favors the survival of recipient T cells, the patient's pretransplantation CMV-specific immunity protects against posttransplantation CMV-related complications.
Keywords AdultAnimalsCytomegalovirus/ immunologyCytomegalovirus Infections/complications/immunology/prevention & controlHematologic Neoplasms/complications/therapyHematopoietic Stem Cell Transplantation/adverse effects/ methodsHumansImmunityLymphocyte DepletionLymphocyte Transfusion/ methodsMiceMiddle AgedRetrospective StudiesT-Cell Antigen Receptor Specificity/immunologyT-Lymphocytes/immunology/ transplantationTreatment Outcome
PMID: 16174767
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Research group Groupe Laurent Kaiser (virologie clinique) (668)
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CHALANDON, Yves et al. Pretransplantation CMV-specific T cells protect recipients of T-cell-depleted grafts against CMV-related complications. In: Blood, 2006, vol. 107, n° 1, p. 389-396. https://archive-ouverte.unige.ch/unige:7139

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Deposited on : 2010-06-21

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