Abstract Lack of virus-specific cell-mediated immunity (CMI) is associated with worse viral infection outcome in hematopoietic stem cell transplantation (HSCT). We aimed to evaluate the role of immunological monitoring of Epstein-Barr virus (EBV) infection in addition to virological one in 33 adult and 18 pediatric allogeneic HSCT recipients. Virological monitoring of infection was performed on whole blood samples by a quantitative real-time PCR assay. Immunological monitoring was performed by Enzyme-linked ImmunoSPOT assay, evaluating EBV-specific CMI, at fixed time-points and when EBV DNAemia was ≥ 10,000 copies/mL. Fifty-one percent of patients developed a post-transplant EBV infection and reduced-intensity conditioning regimen was the only factor associated to infection (P = 0.023). Lack of EBV-specific CMI during active EBV infection was associated with a greater severity of infection. Patients without EBV-specific CMI showed higher median peak level of EBV DNAemia than patients with EBV-specific CMI (P = 0.014), and consequently received more frequently, at EBV DNAemia peak, anti-CD20 therapy (0 versus 54.5%, P = 0.002). No patients with EBV-specific CMI versus 27.2% without EBV-specific CMI developed EBV-related complications (P = 0.063), including two lethal EBV-related post-transplant lymphoproliferative disorders. Combined immunological and virological measurements could improve EBV infection management in HSCT, anticipating the beginning of preemptive treatment from the EBV DNAemia peak to the finding of the lack of EBV-specific CMI.

Clinical utility of measuring Epstein-Barr virus-specific cell-mediated immunity after HSCT in addition to virological monitoring: results from a prospective study / Chiereghin A, Piccirilli G, Belotti T, Prete A, Bertuzzi C, Gibertoni D, Gabrielli L, Turello G, Borgatti EC, Barbato F, Sessa M, Arpinati M, Bonifazi F, Lazzarotto T.. - In: MEDICAL MICROBIOLOGY AND IMMUNOLOGY. - ISSN 0300-8584. - STAMPA. - 208:6(2019), pp. 825-834. [10.1007/s00430-019-00629-2]

Clinical utility of measuring Epstein-Barr virus-specific cell-mediated immunity after HSCT in addition to virological monitoring: results from a prospective study.

Chiereghin A
Writing – Original Draft Preparation
;
Piccirilli G
Investigation
;
Belotti T
Data Curation
;
Prete A
Data Curation
;
Bertuzzi C
Methodology
;
Gibertoni D
Formal Analysis
;
Turello G
Methodology
;
Barbato F
Data Curation
;
Sessa M
Data Curation
;
Arpinati M
Supervision
;
Bonifazi F
Supervision
;
Lazzarotto T.
Writing – Review & Editing
2019

Abstract

Abstract Lack of virus-specific cell-mediated immunity (CMI) is associated with worse viral infection outcome in hematopoietic stem cell transplantation (HSCT). We aimed to evaluate the role of immunological monitoring of Epstein-Barr virus (EBV) infection in addition to virological one in 33 adult and 18 pediatric allogeneic HSCT recipients. Virological monitoring of infection was performed on whole blood samples by a quantitative real-time PCR assay. Immunological monitoring was performed by Enzyme-linked ImmunoSPOT assay, evaluating EBV-specific CMI, at fixed time-points and when EBV DNAemia was ≥ 10,000 copies/mL. Fifty-one percent of patients developed a post-transplant EBV infection and reduced-intensity conditioning regimen was the only factor associated to infection (P = 0.023). Lack of EBV-specific CMI during active EBV infection was associated with a greater severity of infection. Patients without EBV-specific CMI showed higher median peak level of EBV DNAemia than patients with EBV-specific CMI (P = 0.014), and consequently received more frequently, at EBV DNAemia peak, anti-CD20 therapy (0 versus 54.5%, P = 0.002). No patients with EBV-specific CMI versus 27.2% without EBV-specific CMI developed EBV-related complications (P = 0.063), including two lethal EBV-related post-transplant lymphoproliferative disorders. Combined immunological and virological measurements could improve EBV infection management in HSCT, anticipating the beginning of preemptive treatment from the EBV DNAemia peak to the finding of the lack of EBV-specific CMI.
2019
Clinical utility of measuring Epstein-Barr virus-specific cell-mediated immunity after HSCT in addition to virological monitoring: results from a prospective study / Chiereghin A, Piccirilli G, Belotti T, Prete A, Bertuzzi C, Gibertoni D, Gabrielli L, Turello G, Borgatti EC, Barbato F, Sessa M, Arpinati M, Bonifazi F, Lazzarotto T.. - In: MEDICAL MICROBIOLOGY AND IMMUNOLOGY. - ISSN 0300-8584. - STAMPA. - 208:6(2019), pp. 825-834. [10.1007/s00430-019-00629-2]
Chiereghin A, Piccirilli G, Belotti T, Prete A, Bertuzzi C, Gibertoni D, Gabrielli L, Turello G, Borgatti EC, Barbato F, Sessa M, Arpinati M, Bonifazi F, Lazzarotto T.
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/742670
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 7
  • ???jsp.display-item.citation.isi??? 9
social impact