{"doi":"10.1093/cid/ciz1210","title":"Cytomegalovirus (CMV) Cell-Mediated Immunity and CMV Infection After Allogeneic Hematopoietic Cell Transplantation: The REACT Study","abstract":"BACKGROUND: Cytomegalovirus (CMV) infection remains an important cause of morbidity and mortality in allogeneic hematopoietic cell transplant (allo-HCT) recipients. CMV cell-mediated immunity (CMV-CMI) as determined by a peptide-based enzyme-linked immunospot (ELISPOT) CMV assay may identify patients at risk for clinically significant CMV infection (CS-CMVi). METHODS: The CS-CMVi was defined as CMV viremia and/or disease necessitating antiviral therapy. CMV-CMI was characterized as high when the intermediate-early 1 (IE-1) antigen spot counts (SPCs) were >100 (cutoff 1) or when the IE-1 and phosphoprotein 65 antigen SPCs were both >100 SPCs per 250 000 cells (cutoff 2), and a low CMV-CMI when SPCs were below these thresholds. In this prospective multicenter study, we evaluated CMV-CMI every 2 weeks from the pretransplant period until 6 months posttransplantation in 241 allo-HCT recipients with positive CMV serostatus. The primary endpoint was CS-CMVi occurring within 2 weeks of the last measurement of CMV-CMI. RESULTS: CS-CMVi occurred in 70 allo-HCT recipients (29%). CMV-CMI was low in patients who experienced CS-CMVi (94%), whereas those who had a high CMV-CMI were less likely to have CS-CMVi (P < .0001). Patients with CS-CMVi had higher all-cause mortality (P = .007), especially those with low CMV-CMI (P = .035). On multivariable analysis, CMV-CMI, sex, race, antithymocyte globulin, and steroid use were independent predictors of CS-CMVi, and the time from transplant to engraftment was the only predictor of mortality. CONCLUSIONS: Measurement of CMV-CMI using a novel ELISPOT assay would be useful clinically to monitor allo-HCT recipients and distinguish between those at risk of developing CS-CMVi and requiring antiviral prophylaxis or therapy and those who are protected.","journal":"Clinical Infectious Diseases","year":2020,"id":53823,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":111,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9712,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":276585,"name":"Lynn El Haddad","orcid":null,"position":1,"is_corresponding":false},{"id":276586,"name":"Drew J. Winston","orcid":null,"position":2,"is_corresponding":false},{"id":275254,"name":"Scott D. Rowley","orcid":"0000-0002-3299-835X","position":3,"is_corresponding":false},{"id":276587,"name":"Kathleen M Mulane","orcid":null,"position":4,"is_corresponding":false},{"id":275255,"name":"Pranatharthi Chandrasekar","orcid":"0000-0003-0774-1058","position":5,"is_corresponding":false},{"id":275256,"name":"Robin K. Avery","orcid":"0000-0001-7692-3619","position":6,"is_corresponding":false},{"id":122966,"name":"Parameswaran Hari","orcid":"0000-0002-8800-297X","position":7,"is_corresponding":false},{"id":276588,"name":"Karl S. Peggs","orcid":null,"position":8,"is_corresponding":false},{"id":275257,"name":"Deepali Kumar","orcid":"0000-0003-1961-0477","position":9,"is_corresponding":false},{"id":276589,"name":"Rajneesh Nath","orcid":null,"position":10,"is_corresponding":false},{"id":275258,"name":"Per Ljungman","orcid":"0000-0002-8281-3245","position":11,"is_corresponding":false},{"id":275259,"name":"Sherif B. Mossad","orcid":"0000-0002-2394-1423","position":12,"is_corresponding":false},{"id":275260,"name":"Sanjeet Dadwal","orcid":"0000-0002-1099-0568","position":13,"is_corresponding":false},{"id":276590,"name":"Ted Blanchard","orcid":null,"position":14,"is_corresponding":false},{"id":105128,"name":"Dimpy P. Shah","orcid":"0000-0001-9019-8310","position":15,"is_corresponding":false},{"id":275261,"name":"Ying Jiang","orcid":"0000-0001-6381-1458","position":16,"is_corresponding":false},{"id":275262,"name":"Ella Ariza‐Heredia","orcid":"0000-0003-4543-6177","position":17,"is_corresponding":false},{"id":90480,"name":"Roy F. Chemaly","orcid":"0000-0002-0277-3088","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-18T20:45:25.145885Z","pmid":"32076709","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}