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

Luisa Sisinni, Mercedes Gasior, Raquel de Paz, Sergio Querol, David Bueno, Lucia Fernández, Julia Marsal, Ana Sastre, Ramon Gimeno, Laura Alonso, Isabel Badell, Eduardo López-Granados, Juan Torres, Laura Medina, Montserrat Torrent, Cristina Diaz de Heredia, Adela Escudero, Antonio Pérez-Martínez

Research output: Contribution to journalArticleResearch

12 Citations (Scopus)

Abstract

© 2018 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.
Original languageEnglish
Pages (from-to)2316-2323
JournalBiology of Blood and Marrow Transplantation
Volume24
DOIs
Publication statusPublished - 1 Nov 2018

Keywords

  • Encephalitis
  • Haploidentical transplantation
  • Human herpesvirus-6

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