{"doi":"10.1093/ofid/ofad386","title":"Impact of Baseline and Week 2 and Week 4 Posttransplant CMV Cell-Mediated Immunity on Risk of CMV Infections and Mortality in Recipients of Allogeneic Hematopoietic Cell Transplant","abstract":"Abstract Background Cytomegalovirus (CMV) infection is a common opportunistic infection after allogeneic hematopoietic cell transplant (alloHCT). We explored whether a change in CMV cell-mediated immunity during the first month after transplant predicts the risk of development of CMV infection and all-cause mortality. Methods This follow-up analysis is based on data from the REACT study, a multicenter prospective observational study of recipients of alloHCT who were CMV-seropositive. Production of interferon γ following ex vivo stimulation with CMV antigens IE1 (immediate early 1) and pp65 (phosphoprotein 65) was assessed by CMV ELISPOT assay at baseline and 2 and 4 weeks after transplant. Clinically significant CMV infection (CS-CMVi) was defined as CMV viremia and/or disease necessitating antiviral therapy. We evaluated the impact of CMV CMI changes on the risk of CS-CMVi and post transplant mortality. Results The analysis included 226 recipients of alloHCT with CMV cell-mediated immunity data at baseline and 2 and/or 4 weeks after transplant. CS-CMVi occurred in 64 patients (28%). On Cox regression analyses, independent predictors of CS-CMVi included a negative Δ change from baseline to week 2 of pp65 spot counts (hazard ratio, 3.65 [95% CI, 1.65–8.04]; P = .001) to week 4 of IE1 spot counts (hazard ratio, 2.79 [95% CI, 1.46–5.35]; P = .002), anti-thymocyte globulin conditioning regimen, type of transplant, female sex, and corticosteroid use. Kaplan-Meir analysis showed a significant association of a negative IE1 change from baseline to week 4 and increased all-cause mortality after transplant (log rank test = 0.041). Conclusions A decrease in CMV-specific T-cell responses during the first month after transplant may predict CS-CMVi and is associated with all-cause mortality in recipients of alloHCT.","journal":"Open Forum Infectious Diseases","year":2023,"id":344717,"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":13,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9487,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":276586,"name":"Drew J. Winston","orcid":null,"position":1,"is_corresponding":false},{"id":275254,"name":"Scott D. Rowley","orcid":"0000-0002-3299-835X","position":2,"is_corresponding":false},{"id":1083574,"name":"Kathleen M. Mullane","orcid":"0000-0002-8921-8561","position":3,"is_corresponding":false},{"id":275255,"name":"Pranatharthi Chandrasekar","orcid":"0000-0003-0774-1058","position":4,"is_corresponding":false},{"id":122966,"name":"Parameswaran Hari","orcid":"0000-0002-8800-297X","position":5,"is_corresponding":false},{"id":275256,"name":"Robin K. Avery","orcid":"0000-0001-7692-3619","position":6,"is_corresponding":false},{"id":276588,"name":"Karl S. Peggs","orcid":null,"position":7,"is_corresponding":false},{"id":275257,"name":"Deepali Kumar","orcid":"0000-0003-1961-0477","position":8,"is_corresponding":false},{"id":276589,"name":"Rajneesh Nath","orcid":null,"position":9,"is_corresponding":false},{"id":275258,"name":"Per Ljungman","orcid":"0000-0002-8281-3245","position":10,"is_corresponding":false},{"id":275259,"name":"Sherif B. Mossad","orcid":"0000-0002-2394-1423","position":11,"is_corresponding":false},{"id":276585,"name":"Lynn El Haddad","orcid":null,"position":12,"is_corresponding":false},{"id":105128,"name":"Dimpy P. Shah","orcid":"0000-0001-9019-8310","position":13,"is_corresponding":false},{"id":275261,"name":"Ying Jiang","orcid":"0000-0001-6381-1458","position":14,"is_corresponding":false},{"id":376816,"name":"Fareed Khawaja","orcid":"0000-0003-4424-283X","position":15,"is_corresponding":false},{"id":275260,"name":"Sanjeet Dadwal","orcid":"0000-0002-1099-0568","position":16,"is_corresponding":false},{"id":276590,"name":"Ted Blanchard","orcid":null,"position":17,"is_corresponding":false},{"id":90480,"name":"Roy F. Chemaly","orcid":"0000-0002-0277-3088","position":18,"is_corresponding":false},{"id":275262,"name":"Ella Ariza‐Heredia","orcid":"0000-0003-4543-6177","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T01:11:35.133818Z","pmid":"37636519","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":[]}