Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
A ROLE OF HERPES VIRUSES IN GRAFT-VERSUS-HOST DISEASE
Diss Abstr Int [C]; 52(4):573 1991. Unique Identifier : AIDSLINE ICDB/92679459 Bostrom LAS; Karolinska Institutet, Sweden
Abstract:
I, II. In 111 allogeneic bone marrow transplant (BMT) recipients and their HLA-identical donors pretransplant herpes virus antibodies for cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV) and Epstein Barr virus (EBV) were analyzed. The only significant factor for acute graft vs host disease (GVHD) was a positive recipient serology for CMV. Pretransplant serology for CMV, HSV, VZV and EBV were analyzed in 379 BMT recipients and their HLA-identical donors. Recipient seropositivity to 3 or more different herpes viruses, compared to 0-2, was the only significant factor for acute GVHD. If this factor was excluded other significant factors were older donor age, absence of T cell depletion, monotherapy of methotrexate or cyclosporine versus a combination therapy of both, and seropositivity to 3 or more herpes viruses among the donors (compared to 0-2). III. Donor leukocytes from peripheral blood and bone marrow were simultaneously stimulated with antigen prepared from CMV, HSV and VZV. High IgG titers for recipient HSV was associated with acute GVHD. A strong donor blood leukocyte reactivity to HSV antigen in HSV immune donors combined with presence of recipient HSVIgG antibodies was associated with acute GVHD. IV, V. Pretransplant herpes virus status was analyzed in 150 BMT recipients and their HLA-identical donors. Seropositivity to 3-4 different herpes viruses (CMV, HSV, VZV, EBV) vs 0-2 among the donors and a previous grade II-IV acute GVHD were the strongest predictors of chronic GVHD. 285 HLA-identical donors and recipients of allogeneic bone marrow were evaluated for chronic GVHD. The cumulative incidence of chronic GVHD was 32%. Statistically significant factors associated with chronic GVHD were: pretransplant recipient CMV seropositivity in combination with donor CMV seropositivity prior to BMT, a previous grade II-IV acute GVHD and splenectomy prior to BMT. VI. 297 allogeneic BMT-patients (pts) and their HLA-identical donors were evaluated for relapse of leukemia after BMT. The 3-yr cumulative incidence of relapse after BMT was 28%. Statistically significant risk-factors for relapse after BMT were: pts beyond first remission of acute leukemia or first chronic phase of chronic myeloid leukemia (intermediate or advanced leukemia) and pts seropositive to 0-2 different herpes viruses prior to BMT (compared to 3-4). Absence of chronic GVHD was of borderline significance for relapse. (Abstract shortened by UMI.)
Keywords: Antigens, Viral/ANALYSIS Bone Marrow Transplantation Cytomegalovirus/IMMUNOLOGY Graft vs Host Disease/*MICROBIOLOGY Herpesvirus 3, Human/IMMUNOLOGY Herpesvirus 4, Human/IMMUNOLOGY Human HLA Antigens/ANALYSIS Leukemia, Myeloid, Chronic/SURGERY Simplexvirus/IMMUNOLOGY/*ISOLATION & PURIF Transplantation, Homologous THESIS 920630
M9261020
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
