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Monitoring for virus-specific T-cell responses and viremia in allogeneic HSCT recipients: a survey from the EBMT Cellular Therapy & Immunobiology Working Party

Bone Marrow Transplantation volume 58, pages 603–606 (2023)Cite this article

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A number of factors interact to determine the risk of viral infections/reactivations following allogeneic hematopoietic stem cell transplant (HSCT). In the last decade, this issue became even more relevant with the introduction of new transplant platforms, including in particular the growing use of Post-Transplant Cyclophosphamide (PT-Cy) as graft-versus-host disease (GvHD) prophylaxis [1]. Although the recovery is fast and robust among patients treated with PT-Cy, this approach may affect the dynamics and final output of immune reconstitution, as well as impact the risk of infections, exposing HSCT recipients to higher incidence of viral infections [2, 3].

Cytomegalovirus (CMV) represents a relevant complication in HSCT recipients with PT-Cy [4], although the recent advent of letermovir prophylaxis has profoundly changed CMV presentation also in this context [5,6,7,8,9]. Although rare, human herpesvirus 6 (HHV-6) [10] and adenovirus (AdV) [11] have emerged as additional threats in HSCT recipients. This changing epidemiology of viral infections poses new challenges, from post-transplant monitoring to potential prophylactic/therapeutic approaches.

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Fig. 1: Description of centers according to transplant volume and availability of immune reconstitution tests for CMV, HHV6 and AdV.

Data availability

The final analysis dataset will be available upon specific request to the Working Party chair.

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Acknowledgements

This study was led and supported by the EBMT CTIWP. We are grateful to all physicians, nurses, and other staff treating these patients under very challenging circumstances and still being able to help with providing data for this manuscript. We are grateful to the all the EBMT affiliated centers contributing to this survey: University Hospital of Oran, Oran, Algeria; The Children’s Hospital at Westmead, Sydney, Australia; Elisabethinen-Hospital, Linz, Austria; St. Anna Kinderspital, Vienna, Austria; Medizinische Universitaet Wien, Vienna, Austria; Bahrain Oncology Center, Muharraq, Bahrain; Antwerp University Hospital (UZA), Antwerp E, Belgium; ZNA, Antwerp, Belgium; Institut Jules Bordet, Brussels, Belgium; Ribeirao Preto Medical School, University Sao Paulo, Ribeirao Preto, Brazil; National Hospital of Haematological Diseases, Sofia, Bulgaria; Bone Marrow Transplantation Center, Hangzhou, China; Ruijin Hospital, Shanghai, China; Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin, China; Xinqiao Hospital, Chongqing, China; University Hospital Ostrava, Ostrava, Czech Republic; Charles University Hospital, Pilsen, Czech Republic; University Hospital Brno, Brno, Czech Republic; Olomouc University Hospital, Olomouc, Czech Republic; University Hospital Motol, Prague, Czech Republic; Institute of Hematology and Blood Transfusion, Prague, Czech Republic; HUCH Comprehensive Cancer Center, Helsinki, Finland; Institut d’Hematologie et d’Oncologie Pediatrique, Lyon, France; Programme de Transplantation&Therapie Cellulaire, Marseille, France; Gustave Roussy Cancer Campus, Villejuif, France; CHU Nice - Hôpital de l’ARCHET I, Nice, France; Hôpital Robert Debre, Paris, France; Centre Hospitalier Lyon Sud, Lyon, France; Techniciens d’Etude Clinique suivi de patients greffes, Strasbourg, France; Saint-Louis Hospital, BMT Unit, Paris, France; Universitaetsklinikum Dresden, Dresden, Germany; Universitaetsklinikum Wuerzburg, Wuerzburg, Germany; Hannover Medical School, Hannover, Germany; Martin-Luther-Univ. Halle-Wittenberg, Halle, Germany; University Hospital | Tuebingen, Tuebingen, Germany; University Medicine Greifswald, Greifswald, Germany; Justus-Liebig-University Giessen, Giessen, Germany; Medical Clinic and Policinic 1, Leipzig, Germany; Klinikum Karlsruhe gGmbH, Karlsruhe, Germany; Universitaetsklinikum Muenster, Muenster, Germany; Klinik fuer Innere Medzin III, Ulm, Germany; University Children’s Hospital, Wuerzburg, Germany; University Hospital | Essen, Duesseldorf, Germany; Klinikum Nuernberg, Nuernberg, Germany; University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany; University Medical Center Mainz, Mainz, Germany; Evangelismos Hospital, Athens, Greece; George Papanicolaou General Hospital, Thessaloniki, Greece; St Sophia Children’s Hospital, Athens, Greece; Borsod-Abaúj- Zemplén County Central Hospital, Miskolc, Hungary; Central Hospital of Southern Pest, Budapest, Hungary; Children’s Medical Centre/Tehran University of Medical Sciences, Teheran, Iran, Islamic Rep.; Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Rep.; Hope Directorate, Dublin, Ireland; Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel; Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Schneider Children’s Medical Center of Israel, Petach-Tikva, Israel; Hadassah University Hospital, Jerusalem, Israel; Rambam Medical Center, Haifa, Israel; IRCCS Ospedale Policlinico San Martino, Genova, Italy; Centro Trapianti di Midollo Osseo, Monza, Italy; Policlinico G.B. Rossi, Verona, Italy; Clinica di Oncoematologia Pediatrica, Padova, Italy; Istituto Clinico Humanitas, Milano, Italy; Ospedale San Raffaele s.r.l., Milano, Italy; Azienda Ospedaliero Universitaria di Modena Policlinico, Modena, Italy; Azienda Ospedaliero Universitaria di Udine, Udine, Italy; Institute G. Gaslini, Genova, Italy; Univ. La Sapienza, Rome, Italy; Centro Trapianti Unico Di CSE Adulti e Pediatrico A. O Brotzu, Cagliari, Italy; IRRCS Ospedale Pediatrico Bambino Gesù, Rome, Italy; Grande Ospedale Metropolitano Bianchi Melacrino Morelli - Centro Unico Trapianti A. Neri, Reggio C, Italy; Arcispedale S. Maria Nuova, Reggio E, Italy; Az. Ospedaliera S. Croce e Carle, Cuneo, Italy; Fondazione IRCCS - Ca’ Granda, Milano, Italy; Azienda Ospedaliero Universitaria Pisana, Pisa, Italy; ASST Papa Giovanni XXIII, Bergamo, Italy; S. Bortolo Hospital, Vicenza, Italy; USD Trapianti di Midollo, Adulti, Brescia, Italy; Ospedale Civile, Pescara, Italy; Universita Cattolica S. Cuore, Rome, Italy; Ospedale Dell’Angelo, Venezia, Italy; Meyer University Children Hospital, Firenze, Italy; Sezione di Ematologia, Perugia, Italy; Istishari Hospital, Amman, Jordan; King Hussein Cancer Centre, Amman, Jordan; Hospital Ampang, Ampang, Malaysia; Princess Maxima Center/ University Hospital for Children (WKZ), Utrecht, Netherlands; Erasmus MC Cancer Institute, Rotterdam, Netherlands; University Medical Centre, Utrecht, Netherlands; Nijmegen Medical Centre, Nijmegen, Netherlands; University Hospital Maastricht, Maastricht, Netherlands; Leiden University Hospital, Leiden, Netherlands; Oslo University Hospital, Rikshospitalet, Oslo, Norway; Children’s University Hospital, Lublin, Poland; Department of Bone Marrow Transplantation and Oncohematology, Gliwice, Poland; Fundacja “Na Ratunek Dzieciom z Choroba Nowotworowa”, Wroclaw, Poland; University Hospital, Collegium Medicum UMK, Bydgoszcz, Poland; Poznan University of Medical Sciences, Poznan, Poland; Medical University of Gdansk, Gdansk, Poland; Inst. Português de Oncologia do Porto, Porto, Portugal; Inst. Portugues Oncologia, Lisboa, Portugal; National Center for Cancer Care & Research, Doha, Qatar; Emergency Hospital “Louis Turcanu” Timisoara, Timisoara, Romania; Coltea Clinical Hospital, Bucharest, Romania; Fundeni Clinical Institute, Bucharest, Romania; Regional Children’s Hospital, Ekaterinburg, Russia; First State Pavlov Medical University of St. Petersburg, Petersburg, Russian Federation; Federal Research Center for Pediatric Hematology, Moscow, Russian Federation; King Abdul - Aziz Medical City, Riyadh, Saudi Arabia; King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia; King Fahad Medical City, Riyadh, Saudi Arabia; Mother and Child Health Care Institute of Serbia “Dr Vukan Cupic”, Belgrade, Serbia; Singapore General Hospital, Singapore, Singapore; Centre for clinical Haematology, Singapore, Singapore; Pediatric University Teaching Hospital, Bratislava, Slovak Republic; University of Cape Town Faculty of Health Sciences, Cape Town, South Africa; Hospital U. Marqués de Valdecilla, Santander, Spain; Hospital Vall d’Hebron, Barcelona, Spain; Niño Jesus Children’s Hospital, Madrid, Spain; Fundación Jiménez Díaz, Madrid, Spain; Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; Institut Catalá d’Oncologia Hospital Duran i Reynals, Barcelona, Spain; Hospital Universitario La Paz, Madrid, Spain; Hospital Clinic, Barcelona, Spain; Fundació Institut d’Investigació Sanitària Illes Balears IdISBa, Palma, Spain; University Hospital La Fe, Valencia, Spain; Hospital Santa Creu i Sant Pau, Barcelona, Spain; Hospital Clínico de Valencia, Valencia, Spain; Département d’Oncologie, Service d’Hématologie, Geneva, Switzerland; University Children’s Hospital, Zürich, Switzerland; University Hospital | Basel, Basel, Switzerland; Centre National de Greffe de Moelle, Tunis, Tunisia; Altinbas University, Faculty of Medicine, Bahçelievler Medicalpark Hospital, Pediatric Bone Marrow Transplantation Unit, Istanbul, Istanbul, Turkey; Ankara University Faculty of Medicine, Ankara, Turkey; Erciyes University, Faculty of Medicine, Kayseri, Turkey; Gazi University School of Medicine, Ankara, Turkey; Emsey Hospital, Istanbul, Turkey; Baskent University Hospital, Adana, Turkey; Gazi University Faculty of Medicine, Ankara, Turkey; Hacettepe University Children’s Hospital, Ankara, Turkey; Medical Park Antalya Hospital, Antalya, Turkey; Imperial College, London, United Kingdom; University College London Hospital, London, United Kingdom; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; Yorkshire Blood & Marrow Transplant Programme, Leeds, United Kingdom; St. Bartholomew’s and The Royal London NHS Trust, London, United Kingdom; University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom; Royal Marsden Hospital, London, United Kingdom; Southampton General Hospital, Southampton, United Kingdom; Sheffield Childrens NHS Foundation Trust, Sheffield, United Kingdom; Royal Manchester Children’s Hospital, Manchester, United Kingdom.

Funding

The EBMT provided resources via the working party, data office and registry. Other than EBMT support there is no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Unit of Hematology and Bone Marrow Transplantation, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy

    Raffaella Greco, Jacopo Peccatori, Fabio Ciceri, Luca Vago & Annalisa Ruggeri

  2. EBMT Leiden Study Unit, Leiden, The Netherlands

    Jorinde D. Hoogenboom & Edouard F. Bonneville

  3. Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands

    Edouard F. Bonneville

  4. George Papanicolaou General Hospital, Thessaloniki, Greece

    Achilles Anagnostopoulos

  5. Azienda Ospedaliero Universitaria di Modena Policlinico, Modena, Italy

    Angela Cuoghi

  6. Hôpital Robert Debre, Paris, France

    Jean-Hugues Dalle

  7. Hannover Medical School, Hannover, Germany

    Eva M. Weissinger

  8. University Hospital, Tuebingen, Germany

    Peter Lang

  9. IRRCS Ospedale Pediatrico Bambino Gesù, Rome, Italy

    Federica Galaverna

  10. Grande Ospedale Metropolitano Bianchi Melacrino Morelli - Centro Unico Trapianti A. Neri, Reggio Calabria, Italy

    Massimo Martino

  11. Federal Research Center for Pediatric Hematology, Moscow, Russia

    Alexei Maschan

  12. Justus-Liebig-University Giessen, Giessen, Germany

    Christine Mauz-Körholz

  13. Medical Faculty of the Martin-Luther-University of Halle, Halle, Germany

    Christine Mauz-Körholz

  14. Experimental Hematology Unit, Division of Immunology, Transplantation and Infectious Disease, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy

    Maddalena Noviello & Chiara Bonini

  15. University Hospital, Basel, Switzerland

    Jakob Passweg

  16. BMT Unit, Hematology Department, ICMHO, IDIBAPS Hospital Clinic, Josep Carreras Institute, Barcelona, Spain

    Montserrat Rovira

  17. Hospital Clínico Universitario. University of Valencia, Valencia, Spain

    Carlos Solano

  18. Leiden University Hospital, Leiden, Netherlands

    Hendrik Veelken

  19. Bone Marrow Transplantation Program, Division of Hematology and Clinical Immunology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy

    Andrea Velardi

  20. University Medical Center Mainz, Mainz, Germany

    Eva Maria Wagner-Drouet

  21. Medical center of hematology, Xinqiao Hospital, Army Medical University, Chongqing, China

    Xi Zhang

  22. Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milano, Italy

    Fabio Ciceri, Chiara Bonini & Luca Vago

  23. Unit of Immunogenetics, Leukemia Genomics and Immunobiology, San Raffaele Scientific Institute, Milano, Italy

    Luca Vago

  24. Institut Paoli-Calmettes, Centre de Lutte Contre le Cancer; Centre d’Investigations Cliniques en Biothérapies, Université d’Aix-Marseille, Inserm CBT, 1409, Marseille, France

    Christian Chabannon

Authors
  1. Raffaella Greco
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  2. Jorinde D. Hoogenboom
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Contributions

RG, LV, AR and CC led on concept and design, provided expert and analytical feedback, and worked as a writing committee. JH prepared and conducted survey, and prepared data. EB analyzed the data. All others provided data. All authors critically reviewed first a preliminary and then the final version of the manuscript.

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Correspondence to Raffaella Greco.

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Greco, R., Hoogenboom, J.D., Bonneville, E.F. et al. Monitoring for virus-specific T-cell responses and viremia in allogeneic HSCT recipients: a survey from the EBMT Cellular Therapy & Immunobiology Working Party. Bone Marrow Transplant 58, 603–606 (2023). https://doi.org/10.1038/s41409-023-01939-z

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