Unexpected High Incidence of Human Herpesvirus-6 Encephalitis after Naive T Cell-Depleted Graft of Haploidentical Stem Cell Transplantation in Pediatric Patients
Sisinni, Luisa (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Gasior, Mercedes (Hospital Universitario La Paz (Madrid))
de Paz, Raquel (Hospital Universitario La Paz (Madrid))
Querol, Sergio (Centre Frederic Duran i Jordà)
Bueno, David (Hospital Universitario La Paz (Madrid))
Fernández, Lucía (Centro Nacional de Investigaciones Oncológicas)
Marsal, Julia (Sant Joan de Déu Hospital)
Sastre, Ana (Hospital Universitario La Paz (Madrid))
Gimeno, Ramón (Hospital del Mar (Barcelona, Catalunya))
Alonso, Laura (Hospital Universitari Vall d'Hebron)
Badell Serra, Isabel (Institut d'Investigació Biomèdica Sant Pau)
López-Granados, Eduardo (Hospital Universitario La Paz (Madrid))
Torres, Juan (Hospital Universitario La Paz (Madrid))
Medina, Laura (Centre Frederic Duran i Jordà)
Torrent, Montse (Institut d'Investigació Biomèdica Sant Pau)
Díaz de Heredia, Cristina (Hospital Universitari Vall d'Hebron)
Escudero, Adela (Hospital Universitario La Paz (Madrid))
Pérez-Martínez, Antonio (Hospital Universitario La Paz (Madrid))
Universitat Autònoma de Barcelona

Date:	2018
Abstract:	The CD45RA T cell depletion (TCD) method has been used to deplete naive T cells, preventing graft-versus-host disease (GVHD) but preserving memory cells, providing immediate functional T cells with anti-infection, antileukemia, and antirejection effects. We describe a series of 25 consecutive high-risk patients with leukemia who received haploidentical hematopoietic stem cell transplantation (haplo-HSCT) with CD45RA TCD. Each patient received 2 cell products: 1 created by CD34 positive selection and the other through CD45RA depletion from the CD34 negative fraction by a CliniMACS device. CD45RA-depleted haplo-HSCT was well tolerated, with rapid engraftment and low risk of severe acute GVHD and chronic GVHD. Although this treatment achieved a good control of viral reactivations, such as cytomegalovirus and adenovirus, we observed an unexpectedly high rate of limbic encephalitis due to human herpesvirus-6 (HHV-6; 8 cases). Characteristically, the infection appeared early in almost all patients, just after the engraftment. Although no patient died from encephalitis, 1 patient showed neuropsychological sequelae, and another experienced secondary graft failure just after the HHV-6 reactivation.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Encephalitis ; Haploidentical transplantation ; Human herpesvirus-6
Published in:	Biology of blood and marrow transplantation, Vol. 24 Núm. 11 (november 2018) , p. 2316-2323, ISSN 1523-6536

DOI: 10.1016/j.bbmt.2018.07.016
PMID: 30031939

8 p, 1.2 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles