TY - JOUR
T1 - Impact of Specific Antibody Level on Human Herpesvirus 6 Reactivation after Allogeneic Stem Cell Transplantation
T2 - H. Nakayama et al
AU - Nakayama, Hitomi
AU - Yamazaki, Rie
AU - Kato, Jun
AU - Koda, Yuya
AU - Sakurai, Masatoshi
AU - Mori, Takehiko
N1 - Funding Information:
Financial disclosure: This work was supported by the Japan Society for the Promotion of Science (KAKENHI Grant JP17K09961). Conflict of interest statement: T.M. has received research funding from MSD, Novartis Pharma, Kyowa Kirin, Otsuka Pharmaceutical, Japan Blood Products Organization and Asahi Kasei Corporation. M.S. has received research funding from Nippon Shinyaku. Authorship statement: H.N. designed the study, collected the clinical data and samples, performed experiments, analyzed data, and wrote the manuscript. R.Y. and T.M. designed the study, interpreted the results of experiments, and wrote the manuscript. J.K. Y.K. and M.S. took care of the patients and provided important opinions about the manuscript. All authors reviewed and approved the final manuscript. Financial disclosure: See Acknowledgments on page 174.e5.
Funding Information:
Financial disclosure: This work was supported by the Japan Society for the Promotion of Science (KAKENHI Grant JP17K09961).
Publisher Copyright:
© 2020 The American Society for Transplantation and Cellular Therapy
PY - 2021/2
Y1 - 2021/2
N2 - The majority of adults are seropositive for human herpesvirus 6 (HHV-6). HHV-6 reactivation can occur after allogeneic hematopoietic stem cell transplantation (HSCT) and lead to life-threatening central nervous system disorders. In this prospective study, we evaluated the relationship between HHV-6 reactivation and anti-HHV-6 IgG antibody levels in recipients of allogeneic HSCT. The HHV-6 viral load in the plasma was quantitatively measured weekly after allogeneic HSCT by real-time polymerase chain reaction. The level of anti-HHV-6 IgG antibody was measured by enzyme‐linked immunosorbent assay before and serially after transplantation. In 28 of the 56 evaluated patients (50%), HHV-6 reactivation was detected after transplantation. In a multivariate analysis, cord blood as the stem cell source was the only significant factor associated with HHV-6 reactivation (odds ratio, 8.6; 95% confidence interval, 2.3 to 32.6; P < .01). When evaluated in the recipients of cord blood transplantation (CBT), the anti-HHV-6 antibody level before transplantation was significantly lower in the patients with HHV-6 reactivation compared with those without (sample positivity index: median, 2.04 [range, 0.95 to 5.98] versus 4.15 [range, 3.93 to 5.65]; P < .05). The anti-HHV-6 antibody level was significantly decreased at 3 months post-transplantation compared with before transplantation (P < .01). Such differences were not observed in other stem cell sources. Our results demonstrate that the low anti-HHV-6 antibody level before transplantation was associated with the reactivation of HHV-6 after CBT, and that the anti-HHV-6 antibody level was significantly decreased specifically after CBT. These results suggest that HHV-6-specific humoral immunity plays a role in HHV-6 reactivation after CBT.
AB - The majority of adults are seropositive for human herpesvirus 6 (HHV-6). HHV-6 reactivation can occur after allogeneic hematopoietic stem cell transplantation (HSCT) and lead to life-threatening central nervous system disorders. In this prospective study, we evaluated the relationship between HHV-6 reactivation and anti-HHV-6 IgG antibody levels in recipients of allogeneic HSCT. The HHV-6 viral load in the plasma was quantitatively measured weekly after allogeneic HSCT by real-time polymerase chain reaction. The level of anti-HHV-6 IgG antibody was measured by enzyme‐linked immunosorbent assay before and serially after transplantation. In 28 of the 56 evaluated patients (50%), HHV-6 reactivation was detected after transplantation. In a multivariate analysis, cord blood as the stem cell source was the only significant factor associated with HHV-6 reactivation (odds ratio, 8.6; 95% confidence interval, 2.3 to 32.6; P < .01). When evaluated in the recipients of cord blood transplantation (CBT), the anti-HHV-6 antibody level before transplantation was significantly lower in the patients with HHV-6 reactivation compared with those without (sample positivity index: median, 2.04 [range, 0.95 to 5.98] versus 4.15 [range, 3.93 to 5.65]; P < .05). The anti-HHV-6 antibody level was significantly decreased at 3 months post-transplantation compared with before transplantation (P < .01). Such differences were not observed in other stem cell sources. Our results demonstrate that the low anti-HHV-6 antibody level before transplantation was associated with the reactivation of HHV-6 after CBT, and that the anti-HHV-6 antibody level was significantly decreased specifically after CBT. These results suggest that HHV-6-specific humoral immunity plays a role in HHV-6 reactivation after CBT.
KW - Allogeneic hematopoietic stem cell transplantation
KW - Enzyme-linked immunosorbent assay
KW - Human herpesvirus 6
KW - Humoral immunity
KW - Reactivation
UR - http://www.scopus.com/inward/record.url?scp=85101089705&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85101089705&partnerID=8YFLogxK
U2 - 10.1016/j.jtct.2020.10.011
DO - 10.1016/j.jtct.2020.10.011
M3 - Article
C2 - 33830031
AN - SCOPUS:85101089705
SN - 2666-6367
VL - 27
SP - 174.e1-174.e5
JO - Transplantation and Cellular Therapy
JF - Transplantation and Cellular Therapy
IS - 2
ER -
