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Immune Reconstitution After Allogeneic Hematopoietic Stem Cell Transplantation and Association With Occurrence and Outcome of Invasive Aspergillosis

Stuehler, Claudia ; Kuenzli, Esther ; Jaeger, Veronika K. ; Baettig, Veronika ; Ferracin, Fabrizia ; Rajacic, Zarko ; Kaiser, Deborah ; Bernardini, Claudia ; Forrer, Pascal ; Weisser, Maja ; Elzi, Luigia ; Battegay, Manuel ; Halter, Joerg ; Passweg, Jakob ; Khanna, Nina

In: The Journal of Infectious Diseases, 2015, vol. 212, no. 6, p. 959-967

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    Title
    • Immune Reconstitution After Allogeneic Hematopoietic Stem Cell Transplantation and Association With Occurrence and Outcome of Invasive Aspergillosis
    Author
    • Stuehler, Claudia. Infection Biology Laboratory, Department of Biomedicine
    • Kuenzli, Esther. Division of Infectious Diseases and Hospital Epidemiology, Department of Clinical Research
    • Jaeger, Veronika K.. Department of Rheumatology
    • Baettig, Veronika. Division of Infectious Diseases and Hospital Epidemiology, Department of Clinical Research
    • Ferracin, Fabrizia. Infection Biology Laboratory, Department of Biomedicine
    • Rajacic, Zarko. Infection Biology Laboratory, Department of Biomedicine
    • Kaiser, Deborah. Infection Biology Laboratory, Department of Biomedicine
    • Bernardini, Claudia. Infection Biology Laboratory, Department of Biomedicine
    • Forrer, Pascal. Infection Biology Laboratory, Department of Biomedicine
    • Weisser, Maja. Division of Infectious Diseases and Hospital Epidemiology, Department of Clinical Research
    • Elzi, Luigia. Division of Infectious Diseases and Hospital Epidemiology, Department of Clinical Research
    • Battegay, Manuel. Division of Infectious Diseases and Hospital Epidemiology, Department of Clinical Research
    • Halter, Joerg. Division of Hematology, University Hospital of Basel, Switzerland
    • Passweg, Jakob. Division of Hematology, University Hospital of Basel, Switzerland
    • Khanna, Nina. Infection Biology Laboratory, Department of Biomedicine
    Document Type
    • Postprint
    Language
    • English
    Published in
    • The Journal of Infectious Diseases, 2015, vol. 212, no. 6, p. 959-967. Oxford University Press
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:290559
    Summary
    Background. Invasive aspergillosis (IA) remains a leading cause of morbidity and mortality in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). To date, no reliable immunological biomarkers for management and outcome of IA exist. Here, we investigated reconstitution of antifungal immunity in patients during the first 12 months after HSCT and correlated it with IA. Methods. Fifty-one patients were included, 9 with probable/proven IA. We determined quantitative and qualitative reconstitution of polymorphonuclear (PMN), CD4, CD8, and natural killer (NK) cells against Aspergillus fumigatus over 5 time points and compared the values to healthy donors. Results. Absolute CD4 and CD8 cell counts, antigen-specific T-cell responses, and killing capacity of PMN against A. fumigatus were significantly decreased in all patients over 12 months. In patients with probable/proven IA, reactive oxygen species (ROS) production tended to be lower compared to patients without IA, and absolute NK-cell counts remained below 200 cells/µL. Patients with well-controlled IA showed significantly higher ROS production and NK-cell counts compared to patients with poor outcome. Conclusions. This study highlights the importance of functional PMN, T-cell, and NK-cell immunity for the outcome of IA. Larger multicenter studies should address the potential use of NK-cell counts for the management of antifungal therapy