Unexpected High Incidence of Human Herpesvirus-6 Encephalitis after Naive T Cell-Depleted Graft of Haploidentical Stem Cell Transplantation in Pediatric Patients

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• dc.contributor.author Sisinni, Lorenza
• dc.contributor.author Gimeno Martínez, Ramón
• dc.contributor.author Pérez-Martínez, Antonio
• dc.date.accessioned 2019-03-08T09:56:08Z
• dc.date.issued 2018
• dc.description.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.
• dc.format.mimetype application/pdf
• dc.identifier.citation Sisinni L, Gasior M, de Paz R, Querol S, Bueno D, Fernández L. et al. Unexpected High Incidence of Human Herpesvirus-6 Encephalitis after Naive T Cell-Depleted Graft of Haploidentical Stem Cell Transplantation in Pediatric Patients. Biol Blood Marrow Transplant. 2018 Nov;24(11):2316-2323. DOI: 10.1016/j.bbmt.2018.07.016
• dc.identifier.doi http://dx.doi.org/10.1016/j.bbmt.2018.07.016
• dc.identifier.issn 1083-8791
• dc.identifier.uri http://hdl.handle.net/10230/36775
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Biology of Blood and Marrow Transplantation. 2018 Nov;24(11):2316-23
• dc.rights © Elsevier http://dx.doi.org/10.1016/j.bbmt.2018.07.016
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.subject.keyword Encephalitis
• dc.subject.keyword Haploidentical transplantation
• dc.subject.keyword Human herpesvirus-6
• dc.subject.other Encefalitis
• dc.subject.other Pediatria
• dc.title Unexpected High Incidence of Human Herpesvirus-6 Encephalitis after Naive T Cell-Depleted Graft of Haploidentical Stem Cell Transplantation in Pediatric Patients
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/acceptedVersion