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The Establishment of a CMV-Specific CD8 + T-Cell Threshold by Kinetic Modelling for Prediction of Post-HSCT Reactivation

The dynamic interaction between CMV virus and host immune response remains 32 obscure, thus hindering the diagnosis and therapeutic management of HSCT patients. 33 Current diagnosis of CMV viremia depends on viral load estimation. Medical 34 intervention based on viral load, can be unnecessary or poorly timed for many 35 patients. Here we examined the clinical features and blood samples of HSCT patients, 36 and assessed the CMV reactivation kinetics and corresponding CMV antigen specific 37 T cell response in individual patients based on a peptide pool stimulation T cell assay, 38 which showed that CMV-specific CD8 + T cells were more suitable to be a diagnosis 39 indicator for suppressing CMV reactivation. Using ROC analysis, we defined and 40 verified a CMV-specific CD8 + T cell counts threshold (925 cells/10 6 PBMCs) as an 41 indicator of CMV reactivation post-HSCT, and suggested that use of this threshold 42 would provide more accurate guidance for prompt medication and better management 43 of CMV infection post-HSCT. 44 47