Impact of CMV and EBV on immune recovery after allogeneic hematopoietic cell transplantation in children

Abstract

Background/Aim: Immune recovery is a key factor in the management of patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). This study analyzed the factors contributing to immune reconstitution after allo-HSCT. Patients and Methods: Overall, 65 children with malignant or non-malignant diseases were included in multivariate analyses. Results: The following factors contributed to a faster immune recovery: peripheral blood as a stem cell source and reactivation of CMV infection for CD3+ and CD4+ lymphocyte subpopulations; reactivation of CMV infection for CD8+ subset; donor EBV-IgG+ and no EBV reactivation for CD19 lymphocytes; recipient age below 10 years and peripheral blood as a stem cell source for NK cells. For CD2 and CD4/CD8 ratio no factor was significant in multivariate analysis. Conclusion: Patients receiving a graft from an EBV-IgG-positive donor and not having early EBV posttransplant viremia show faster recovery of the B-cells, while patients with early CMV-DNA-emia have a better reestablishment of T-cell subsets.