The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation
Specific major histocompatibility (MHC) class I alleles dominate anti-CMV responses in a hierarchal manner. These CMV immunodominant (IMD) alleles are associated with a higher magnitude and frequency of cytotoxic lymphocyte responses as compared to other human leukocyte antigen (HLA) alleles. CMV re...
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doaj-259f4600aa3b4500b50ebcee8c7df9332020-11-25T00:47:58ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2019-09-01910.3389/fonc.2019.00888487053The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell TransplantationDolores Grosso0Benjamin Leiby1Matthew Carabasi2Joanne Filicko-O'Hara3Sameh Gaballa4William O'Hara5John L. Wagner6Neal Flomenberg7Blood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesPharmacology and Experimental Therapeutics, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesBlood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesBlood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesBlood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesBlood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesBlood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesBlood and Marrow Transplant Program, The Sidney Kimmel Cancer Center at Thomas Jefferson University, Philadelphia, PA, United StatesSpecific major histocompatibility (MHC) class I alleles dominate anti-CMV responses in a hierarchal manner. These CMV immunodominant (IMD) alleles are associated with a higher magnitude and frequency of cytotoxic lymphocyte responses as compared to other human leukocyte antigen (HLA) alleles. CMV reactivation has been associated with an increased incidence of graft-vs.-host disease and non-relapse mortality, as well as protection from relapse in HLA-matched HSCT settings. Less is known about the impact of CMV reactivation on these major outcomes after haploidentical (HI) HSCT, an increasingly applied therapeutic option. In HI HSCT, the efficiency of the immune response is decreased due to the immune suppression required to cross the MHC barrier as well as MHC mismatch between presenting and responding cells. We hypothesized that the presence of a CMV IMD allele would increase the efficiency of CMV responses after HI HSCT potentially impacting CMV-related outcomes. In this retrospective, multivariable review of 216 HI HSCT patients, we found that CMV+ recipients possessing at least 1 of 5 identified CMV IMD alleles had a lower hazard of death (HR = 0.40, p = 0.003) compared to CMV+ recipients not possessing a CMV IMD allele, and an overall survival rate similar to their CMV– counterparts. The analysis delineated subgroups within the CMV+ population at greater risk for death due to CMV reactivation.https://www.frontiersin.org/article/10.3389/fonc.2019.00888/fullCMVimmunodominant allelehaploidenticaltransplant outcomesgraft versus host diseaseDNA terminase complex inhibitor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Dolores Grosso Benjamin Leiby Matthew Carabasi Joanne Filicko-O'Hara Sameh Gaballa William O'Hara John L. Wagner Neal Flomenberg |
spellingShingle |
Dolores Grosso Benjamin Leiby Matthew Carabasi Joanne Filicko-O'Hara Sameh Gaballa William O'Hara John L. Wagner Neal Flomenberg The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation Frontiers in Oncology CMV immunodominant allele haploidentical transplant outcomes graft versus host disease DNA terminase complex inhibitor |
author_facet |
Dolores Grosso Benjamin Leiby Matthew Carabasi Joanne Filicko-O'Hara Sameh Gaballa William O'Hara John L. Wagner Neal Flomenberg |
author_sort |
Dolores Grosso |
title |
The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation |
title_short |
The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation |
title_full |
The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation |
title_fullStr |
The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation |
title_full_unstemmed |
The Presence of a CMV Immunodominant Allele in the Recipient Is Associated With Increased Survival in CMV Positive Patients Undergoing Haploidentical Hematopoietic Stem Cell Transplantation |
title_sort |
presence of a cmv immunodominant allele in the recipient is associated with increased survival in cmv positive patients undergoing haploidentical hematopoietic stem cell transplantation |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2019-09-01 |
description |
Specific major histocompatibility (MHC) class I alleles dominate anti-CMV responses in a hierarchal manner. These CMV immunodominant (IMD) alleles are associated with a higher magnitude and frequency of cytotoxic lymphocyte responses as compared to other human leukocyte antigen (HLA) alleles. CMV reactivation has been associated with an increased incidence of graft-vs.-host disease and non-relapse mortality, as well as protection from relapse in HLA-matched HSCT settings. Less is known about the impact of CMV reactivation on these major outcomes after haploidentical (HI) HSCT, an increasingly applied therapeutic option. In HI HSCT, the efficiency of the immune response is decreased due to the immune suppression required to cross the MHC barrier as well as MHC mismatch between presenting and responding cells. We hypothesized that the presence of a CMV IMD allele would increase the efficiency of CMV responses after HI HSCT potentially impacting CMV-related outcomes. In this retrospective, multivariable review of 216 HI HSCT patients, we found that CMV+ recipients possessing at least 1 of 5 identified CMV IMD alleles had a lower hazard of death (HR = 0.40, p = 0.003) compared to CMV+ recipients not possessing a CMV IMD allele, and an overall survival rate similar to their CMV– counterparts. The analysis delineated subgroups within the CMV+ population at greater risk for death due to CMV reactivation. |
topic |
CMV immunodominant allele haploidentical transplant outcomes graft versus host disease DNA terminase complex inhibitor |
url |
https://www.frontiersin.org/article/10.3389/fonc.2019.00888/full |
work_keys_str_mv |
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