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Blood, 15 August 2006, Vol. 108, No. 4, pp. 1406-1412.
Prepublished online as a Blood First Edition Paper on April 13, 2006; DOI 10.1182/blood-2005-11-012864.
 Previous Article | Next Article 
Submitted November 25, 2005
Accepted March 28, 2006
Prospective simultaneous quantification of human
cytomegalovirus-specific CD4+ and CD8+ T-cell
reconstitution in young recipients of allogeneic
hematopoietic stem cell transplantation
Daniele Lilleri, Giuseppe Gerna*, Chiara Fornara, Laura Lozza, Rita Maccario, and Franco Locatelli
Servizio di Virologia, IRCCS Policlinico San Matteo, Pavia, Italy
Lab. Sperimentali di Ricerca, Area Trapiantologica, IRCCS Policlinico San Matteo, Pavia
Unita di Oncoematologia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy
* Corresponding author; email: g.gerna{at}smatteo.pv.it.
We investigated immune reconstitution against human
cytomegalovirus (HCMV) in 57 hematopoietic stem cell
transplantation (HSCT) recipients, aged 1-24 years,
through a novel method combining T-cell stimulation by
HCMV-infected autologous dendritic cells with
simultaneous cytometric quantification of HCMV-specific,
IFN -producing CD4+ and CD8+ T-cells.
Lymphoproliferative response (LPR) to HCMV antigens was
also determined. Patients were stratified into 2 groups
according to HCMV serostatus, comprising 39 HCMV-
seropositive (R+), and 18 HCMV-seronegative (R-)
patients transplanted from a seropositive donor,
respectively. Recovery of both HCMV-specific CD4+ and
CD8+ T-cell immunity occurred in all 39 R+ patients
within 6 months and in 6/18 (33%) R- patients within 12
months. In R+ patients, the median numbers of HCMV-
specific CD8+ and CD4+ T-cells were significantly higher
than those of healthy controls, starting from day +60
and + 180, respectively. In R- patients, the median
numbers of HCMV-specific T-cells were consistently lower
than in R+ patients. LPR was delayed as compared to
reconstitution of IFN -producing T-cells. Patients with
delayed specific immune reconstitution experienced
recurrent episodes of HCMV infection. HCMV-
seropositivity of young HSCT recipients is the major
factor responsible for HCMV-specific immune
reconstitution, irrespective of donor serostatus, and
measurement of HCMV-specific T-cells appears useful for
correct management of HCMV infection.
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