ArticleJournal of Korean medical science2026
Harnessing Cytomegalovirus DNAemia and CMV-Specific Cell-Mediated Immunity in Pediatric Allogeneic Hematopoietic Stem Cell Transplant Recipients.
Article in Journal of Korean medical science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRecovery via cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) in pediatric hematopoietic stem cell transplantation (HSCT) recipients is associated with a lower incidence of significant CMV DNAemia and disease. This study aimed to determine whether early post-HSCT CMI monitoring could predict CMV infection outcomes and identify factors that influence CMI recovery.
methodsPediatric patients (≤ 19 years) undergoing allogeneic HSCT at Asan Medical Center Children's Hospital between August 2018 and February 2020 were prospectively enrolled. CMV-specific CMI was assessed using the enzyme-linked immunospot assay for phosphoprotein 65 (pp65) or immediate-early protein 1 (IE-1) antigens at pre-transplantation, and 1 and 3 months post-transplantation. Plasma CMV polymerase chain reaction monitoring was conducted regularly, and the incidence of CMV DNAemia and CMV disease was evaluated over a two-year follow-up period.
resultsOf the 55 enrolled pediatric recipients, CMV DNAemia occurred in 74.5%, with 21.8% of cases progressing to significant CMV DNAemia. Cumulative CMI recovery rates at 3 months were 61.8% for pp65 and 43.6% for IE-1. Recipients with a cumulative recovery of pp65-specific CMI exhibited a significantly lower incidence of significant CMV DNAemia and CMV disease. In contrast, the cumulative recovery of IE-1-specific CMI was not associated with CMV outcomes. In the multivariate analysis, haploidentical donor status and post-HSCT CMV DNAemia were independently associated with impaired cumulative recovery of both pp65- and IE-1-specific CMI.
conclusionMonitoring pp65-specific CMI recovery within three months post-HSCT is valuable for predicting significant CMV infection in pediatric recipients. Haploidentical HSCT recipients demonstrated impaired CMI recovery, highlighting the need for careful monitoring and tailored prophylactic strategies.
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