The immunosuppressive effect of human cytomegalovirus infection in recipients of allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplant. 2005 Sep;36(6):503-9. doi: 10.1038/sj.bmt.1705094.

Abstract

In immune-competent individuals, human cytomegalovirus (HCMV) infection is associated with impairment of T-cell function. Our goal was to evaluate prospectively whether clinically asymptomatic HCMV infection in allogeneic hematopoietic stem cell transplantation (alloHSCT) recipients, treated pre emptively with ganciclovir, influences T-cell function as well. Mitogen-stimulated T-cell proliferative activity, together with cell surface markers, was tested in 49 patients on days + 30, + 45, + 60, and + 90 after alloHSCT and, additionally, in cases of positive HCMV pp65-antigenemia. HCMV infection was diagnosed in 19 patients. None of them developed HCMV disease. T-cell proliferative activity was significantly decreased on days when HCMV antigenemia was positive as compared to days without antigenemia. The number of pp65-positive cells negatively correlated with proliferative response. Comparison of patients who did experience HCMV infection with those who did not reveals significant decrease of T-cell proliferative activity observed on days + 30 and + 45, a time period when antigenemia was most frequently found to be positive, whereas no difference was detected on days + 60 and + 90. We conclude that, even clinically asymptomatic, HCMV infection has negative impact on T-cell proliferation capacity in alloHSCT recipients. However, pre emptive therapy with ganciclovir makes this immunosuppressive effect transient and restricted to the time of infection duration.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cell Proliferation / drug effects
  • Child
  • Child, Preschool
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / etiology
  • Cytomegalovirus Infections / immunology*
  • Female
  • Ganciclovir / pharmacology
  • Ganciclovir / therapeutic use
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immune Tolerance*
  • Infant
  • Lymphocyte Activation / drug effects
  • Male
  • Mitogens / pharmacology
  • Premedication
  • T-Lymphocytes / immunology
  • T-Lymphocytes / virology
  • Time Factors
  • Transplantation, Homologous

Substances

  • Mitogens
  • Ganciclovir