Department of Laboratory Medicine, MD Anderson Cancer Center, Houston, TX, United States.
Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, United States.
Front Immunol. 2018 Oct 23;9:2444. doi: 10.3389/fimmu.2018.02444. eCollection 2018.
Cytomegalovirus (CMV) remains a major cause of morbidity following allogeneic hematopoietic stem cell transplant. Natural killer cells expressing have been shown to play a role in the immune surveillance of human CMV. We studied copy number in the donor graft and the risk of CMV reactivation after double umbilical cord blood transplantation (DUCBT) in 100 CMV seropositive DUCBT recipients and their corresponding cord blood (CB) grafts ( = 200). In the setting of DUCBT, the combined graft may contain 0-4 functional copies of gene. Sixteen patients received a combined graft with 1 or 2 copies and 84 patients were recipients of a combined graft with 3 or 4 copies. The 6-month cumulative incidence of CMV reactivation for the two groups was 93.7 and 58.4%, respectively ( = 0.0003). In multivariate analysis, low copies in the graft was an independent predictor of CMV reactivation (HR = 2.72, CI = 1.59-4.64; < 0.0001). Our study points to an important role for donor for protection against CMV reactivation after DUCBT. These novel findings may help identify patients at a higher risk of CMV reactivation after DUCBT. Donor genotype may be used as a potential criterion in the algorithm for graft selection for DUCBT.
巨细胞病毒（CMV）仍然是异基因造血干细胞移植后发病率的主要原因。表达 的自然杀伤细胞已被证明在人类 CMV 的免疫监测中发挥作用。我们研究了 100 名 CMV 血清阳性双脐血移植（DUCBT）受者及其相应的脐血（CB）移植物（= 200）中供体移植物中的 拷贝数与 CMV 再激活的风险。在 DUCBT 的情况下，联合移植物可能含有 0-4 个功能拷贝的 基因。16 名患者接受了含有 1 或 2 个 拷贝的联合移植物，84 名患者接受了含有 3 或 4 个 拷贝的联合移植物。两组患者的 6 个月 CMV 再激活累积发生率分别为 93.7%和 58.4%（= 0.0003）。多变量分析显示，移植物中低 的拷贝数是 CMV 再激活的独立预测因子（HR = 2.72，CI = 1.59-4.64；<0.0001）。我们的研究表明供体 对 DUCBT 后 CMV 再激活具有重要保护作用。这些新发现可能有助于确定 DUCBT 后 CMV 再激活风险较高的患者。供体 基因型可用作 DUCBT 移植物选择算法的潜在标准。
