Kinetics of Torque Teno virus DNA in stools may predict occurrence of acute intestinal graft versus host disease early after allogeneic hematopoietic stem cell transplantation.

Autores de IIS La Fe

• José Luis Piñana Sánchez

  Autor

• María Dolores Gómez Ruiz

  Autor

• Eva María González Barberá

  Autor

• Juan Bautista Montoro Gómez

  Autor

• Manuel Nuno Direito De Morais Guerreiro

  Autor

• Aitana Balaguer Roselló

  Autor

• Jaime Sanz Caballer

  Autor

Participantes ajenos a IIS La Fe

• Bueno F
• Albert E
• Pérez A
• Úbeda C
• Hernández-Boluda JC
• Giménez E
• Hernani R
• Solano C
• Navarro D

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

• Infección Grave

  

  Investigador Principal

  María Ángeles Tormo Mas

Abstract

Torque Teno virus (TTV) DNA load in blood may act as a marker of immune competence after allogeneic hematopoietic stem cell transplant recipients (allo-HSCT). Conflicting data have been reported as to the value of this biomarker for anticipating acute Graft-versus-host disease (aGvHD) occurrence. Here, we hypothesized that quantitation of TTV DNA load in stool specimens early after allo-HSCT could be used to identify patients at high risk of acute intestinal graft-versus-host disease (aIGvHD). In this prospective two-center study we recruited a total of 83 non-consecutive adult patients undergoing allo-HSCT. The study period comprised the first 120 days after allo-HSCT. TTV DNA was quantitated in paired stool samples collected at a median of 2 days prior to cell infusion and at a median of 14 days after allo-HSCT by real-time PCR. Thirty-seven patients developed aGVHD, of whom 25 had aIGVHD (diagnosed at a median of 42 days after allo-HSCT). Median TTV DNA load values in post-transplant stools specimens were comparable (P=0.34) in patients with or without subsequent aIGvHD; nevertheless, a falling trajectory (decrease in TTV DNA load >0.5 log 10 copies/0.1 g) in paired pre-transplant and pos-transplant specimens was independently associated with the occurrence of aIGvHD (OR, 5.2; 95% CI, 1.3-21.3; P = 0.02). Notably, displaying a rising trajectory had a negative predictive value of 87.5% for aIGvHD. In summary, in this hypothesis-generating study we suggest that the decrease in TTV DNA load from baseline in stool specimens may identify patients at risk of aIGVHD.

Keywords

• Torque Teno virus (TTV), allogeneic hematopoietic stem cell transplantation, intestinal aGvHD, kinetics of TTV DNA in stools