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EBMT 2021 | REACT: ELISPOT assay predicts CMV reactivation in allo-HSCT patients

Roy F Chemaly, MD, MPH, FIDSA, FACP, MD Anderson Cancer Center, Houston, TX, shares an update on the REACT study (NCT02470208) which is assessing the use of a peptide-based enzyme-linked immunospot (ELISPOT) cytomegalovirus (CMV) assay to identify patients receiving allogeneic hematopoietic stem cell transplant (allo-HSCT) who are at risk of a clinically significant CMV infection. CMV cell-mediated immunity (CMV-CMI) was evaluated both pre- and post-transplant in 241 allo-HSCT recipients with positive CMV serostatus. Out of 241 allo-HSCT recipients, clinically significant CMV infection occurred in 29%. CMV-CMI was low in 94% of these patients. Patients with high CMV-CMI were less likely to have a clinically significant CMV infection. This interview took place during the 47th Annual Meeting of the European Group for Blood and Marrow Transplantation (EBMT) 2021.

Transcript (edited for clarity)

For the REACT study, which was published recently in Clinical Infectious Diseases, it was a multicenter international study testing in the ELISPOT assay for CMV, which is an interferon gamma release assay with the ELISPOT platform, trying to see if this new test can predict CMV reactivation after allogenic STEM cell transplantation.

And what we found that this was really an independent predictor of protection against the CMV reactivation, if you have enough solar mediated immunity for CMV that you can identify by the ELISPOT assay...

For the REACT study, which was published recently in Clinical Infectious Diseases, it was a multicenter international study testing in the ELISPOT assay for CMV, which is an interferon gamma release assay with the ELISPOT platform, trying to see if this new test can predict CMV reactivation after allogenic STEM cell transplantation.

And what we found that this was really an independent predictor of protection against the CMV reactivation, if you have enough solar mediated immunity for CMV that you can identify by the ELISPOT assay. So, it was a positive study, but at the same time, what we saw in a subgroup analysis that patient will have low cellular mediated immunity and had a CMV reactivation, they had the worst outcome. It [inaudible] in mortality compared to patients who had good CMV cellular immunity and no CMV reactivation for example.

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Disclosures

Dr Roy F Chemaly, MD, MPH, FIDSA, FACP, has received research Grants from Gilead, Pulmotec, Janssen, Karius, Chimerix, Merck, Viracor, Takeda/Shire, and Ansun Pharmaceuticals; and has participated in advisory boards or consultancy work for ADMA Biologics, Pulmotec, Ablynx, Janssen, Merck, Takeda, ReViral, Kyorin, Chimerix, Partner Therapeutics, and Ansun Pharmaceuticals.

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