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Peripheral blood regulatory T cells and occurrence of Cytomegalovirus DNAemia after unmanipulated haploidentical allogeneic hematopoietic stem cell transplantation with posttransplant cyclophosphamide

Bone Marrow Transplantation volume 55, pages 1493–1496 (2020)Cite this article

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Cytomegalovirus (CMV) DNAemia remains a clinically relevant problem following allogeneic stem cell transplantation (allo-HSCT) [1]. Currently, enumeration of IFN-γ-producing CMV-specific T cells provides helpful yet improvable data for patient stratification for risk of primary or recurrent CMV DNAemia and for predicting clinically refractory episodes of CMV DNAemia [1].

Regulatory T cells (Tregs) are crucial in preventing graft-versus-host disease (GvHD) while allowing preservation of graft-versus-tumor responses [2]. Although theoretically Treg may compromise antigen-specific T-cell responses, data obtained in allo-HSCT recipients suggest that they enhance immune reconstitution [3]. Despite the above, contradictory data have been reported as to the risk of CMV infection according to PB Treg counts at different time points after allo-HSCT [3,4,5,6,7]. Here, we characterized PB Treg dynamics following unmanipulated haploidentical allo-HSCT with posttransplant cyclophosphamide (PT/Cy-haplo), investigated whether it correlates with the kinetics of CMV-specific T-cell reconstitution, and assessed the potential impact of CMV DNAemia on PB Treg reconstitution. In addition, we aimed at determining whether PB Treg levels early after transplantation may predict occurrence of CMV DNAemia in this setting.

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Fig. 1: Reconstitution of peripheral blood regulatory T cells through day +180 in patients undergoing unmanipulated haploidentical allogeneic hematopoietic stem cell transplantation with posttransplant cyclophosphamide.

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Acknowledgements

EG holds a Juan Rodés research contract from the Carlos III Health Institute (Ref.JR18/00053). EA holds a Río Hortega research contract from the Carlos III Health Institute (Ref.CM18/00221).

Funding

This work was supported by a Fondo de Investigaciones Sanitarias (FIS) grant from Carlos III Health Institute (15/0060).

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Author notes

  1. José Luis Piñana

    Present address: Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain

Authors and Affiliations

  1. Microbiology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain

    Dixie Huntley, Estela Giménez, Eliseo Albert & David Navarro

  2. Hematology Service, Hospital Regional Universitario, Málaga, Spain

    María Jesús Pascual & Beatriz Gago

  3. Hematology Service, Hospital Clínico Universitario, Salamanca, Spain

    Lourdes Vázquez & Magdalena García

  4. Hematology Service, Hospital Clínico Universitario, INCLIVA Research Institute, Valencia, Spain

    Paula Amat, María José Remigia, Juan Carlos Hernández-Boluda, José Luis Piñana, Ariadna Pérez & Carlos Solano

  5. Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain

    Paula Amat, Juan Carlos Hernández-Boluda & Carlos Solano

  6. Hematology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Marta Hernández

  7. Department of Microbiology, School of Medicine, University of Valencia, Valencia, Spain

    Juan Alberola, Roberto Gozalbo-Rovira & David Navarro

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Correspondence to David Navarro.

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Huntley, D., Giménez, E., Pascual, M.J. et al. Peripheral blood regulatory T cells and occurrence of Cytomegalovirus DNAemia after unmanipulated haploidentical allogeneic hematopoietic stem cell transplantation with posttransplant cyclophosphamide. Bone Marrow Transplant 55, 1493–1496 (2020). https://doi.org/10.1038/s41409-020-0950-1

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