tetano
Editor, Senior Moderator
Biol Blood Marrow Transplant. 2010 Aug 10. [Epub ahead of print]
Humoral and cellular immunity to primary H1N1 infection in patients with hematological malignancies and following stem cell transplantation.
Garland P, de Lavallade H, Sekine T, Hoschler K, Sriskandan S, Patel P, Brett S, Stringaris K, Loucaides E, Howe K, Marin D, Kanfer E, Cooper N, Macdonald D, Rahemtulla A, Atkins M, Danga A, Milojkovic D, Gabriel I, Khoder A, Alsuliman A, Apperley J, Rezvani K.
Department of Hematology, Imperial College London, U.K.
Abstract
Limited data on immunological responses to primary H1N1 infection in patients with hematological malignancies are available. We present a prospective, case-surveillance study of such patients with real-time polymerase chain reaction (RT-PCR) confirmed H1N1-influenza who presented to our institution between September 2009 and January 2010. Ninety-two patients presented with influenza-like symptoms and H1N1 infection was confirmed by RT-PCR in 13, including 4 allogeneic stem cell transplant recipients (1 AML, 1 CLL, 1 NHL and 1 CML), 5 patients with multiple myeloma following autologous stem cell transplantation, 1 patient with multiple myeloma peri-mobilization, 2 patients with NHL post chemotherapy and 1 patient with CLL. All 13 required hospitalization. Six (43%) were admitted to the intensive care unit (ICU) of whom 4 (67%) died. We evaluated B and T-cell responses to H1N1 infection prospectively in these patients compared to 4 otherwise healthy controls. Within 12 weeks of diagnosis, only 6/11 patients developed seropositive antibody titers as measured by hemagglutination-inhibition or microneutralization assays compared to 4/4 'controls'. H1N1-specific T-cells were detected in only 2/8 evaluable patients compared to all 'controls'. H1N1-specific T-cells were functional, capable of producing interferon-gamma, TNF-alpha and CD107a mobilization. Furthermore, CD154 was upregulated on CD4+ T-cells in 3/4 controls and 2/2 patients in whom both B and T-cell responses to H1N1 were present. Post H1N1 infection, 5/8 patients developed seasonal influenza specific T-cells, suggesting cross-reactivity induced by H1N1 infection. These data offer novel insights into humoral and cell-mediated immunological responses to primary H1N1 infection.
PMID: 20708085 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20708085
Humoral and cellular immunity to primary H1N1 infection in patients with hematological malignancies and following stem cell transplantation.
Garland P, de Lavallade H, Sekine T, Hoschler K, Sriskandan S, Patel P, Brett S, Stringaris K, Loucaides E, Howe K, Marin D, Kanfer E, Cooper N, Macdonald D, Rahemtulla A, Atkins M, Danga A, Milojkovic D, Gabriel I, Khoder A, Alsuliman A, Apperley J, Rezvani K.
Department of Hematology, Imperial College London, U.K.
Abstract
Limited data on immunological responses to primary H1N1 infection in patients with hematological malignancies are available. We present a prospective, case-surveillance study of such patients with real-time polymerase chain reaction (RT-PCR) confirmed H1N1-influenza who presented to our institution between September 2009 and January 2010. Ninety-two patients presented with influenza-like symptoms and H1N1 infection was confirmed by RT-PCR in 13, including 4 allogeneic stem cell transplant recipients (1 AML, 1 CLL, 1 NHL and 1 CML), 5 patients with multiple myeloma following autologous stem cell transplantation, 1 patient with multiple myeloma peri-mobilization, 2 patients with NHL post chemotherapy and 1 patient with CLL. All 13 required hospitalization. Six (43%) were admitted to the intensive care unit (ICU) of whom 4 (67%) died. We evaluated B and T-cell responses to H1N1 infection prospectively in these patients compared to 4 otherwise healthy controls. Within 12 weeks of diagnosis, only 6/11 patients developed seropositive antibody titers as measured by hemagglutination-inhibition or microneutralization assays compared to 4/4 'controls'. H1N1-specific T-cells were detected in only 2/8 evaluable patients compared to all 'controls'. H1N1-specific T-cells were functional, capable of producing interferon-gamma, TNF-alpha and CD107a mobilization. Furthermore, CD154 was upregulated on CD4+ T-cells in 3/4 controls and 2/2 patients in whom both B and T-cell responses to H1N1 were present. Post H1N1 infection, 5/8 patients developed seasonal influenza specific T-cells, suggesting cross-reactivity induced by H1N1 infection. These data offer novel insights into humoral and cell-mediated immunological responses to primary H1N1 infection.
PMID: 20708085 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20708085