Viruses, Vol. 13, Pages 1530: Consequence of Histoincompatibility beyond GvH-Reaction in Cytomegalovirus Disease Associated with AllogeneicHematopoietic Cell Transplantation: Change of Paradigm

Viruses, Vol. 13, Pages 1530: Consequence of Histoincompatibility beyond GvH-Reaction in Cytomegalovirus Disease Associated with AllogeneicHematopoietic Cell Transplantation: Change of Paradigm Viruses doi: 10.3390/v13081530 Authors: Matthias J. Reddehase Rafaela Holtappels Niels A. W. Lemmermann Hematopoietic cell (HC) transplantation (HCT) is the last resort to cure hematopoietic malignancies that are refractory to standard therapies. Hematoablative treatment aims at wiping out tumor cells as completely as possible to avoid leukemia/lymphoma relapse. This treatment inevitably co-depletes cells of hematopoietic cell lineages, including differentiated cells that constitute the immune system. HCT reconstitutes hematopoiesis and thus, eventually, also antiviral effector cells. In cases of an unrelated donor, that is, in allogeneic HCT, HLA-matching is performed to minimize the risk of graft-versus-host reaction and disease (GvHR/D), but a mismatch in minor histocompatibility antigens (minor HAg) is unavoidable. The transient immunodeficiency in the period between hematoablative treatment and reconstitution by HCT gives latent cytomegalovirus (CMV) the chance to reactivate from latently infected donor HC or from latently infected organs of the recipient, or from both. Clinical experience shows that HLA and/or minor-HAg mismatches increase the risk of complications from CMV. Recent results challenge the widespread, though never proven, view of a mechanistic link betwe...
Source: Viruses - Category: Virology Authors: Tags: Review Source Type: research