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International Journal of Hematology

, Volume 97, Issue 2, pp 287–290 | Cite as

Detection of donor-derived CMV-specific T cells in cerebrospinal fluid in a case of CMV meningoencephalitis after cord blood stem cell transplantation

  • Kazuhiro Ikegame
  • Ruri Kato
  • Tatsuya Fujioka
  • Masaya Okada
  • Katsuji Kaida
  • Shinichi Ishii
  • Satoshi Yoshihara
  • Takayuki Inoue
  • Kyoko Taniguchi
  • Hiroya Tamaki
  • Toshihiro Soma
  • Hiroyasu OgawaEmail author
Case Report

Abstract

Cytomegalovirus (CMV) meningoencephalitis is a rather rare complication after allogeneic stem cell transplantation. We describe here the case of a 59-year-old man with acute myeloid leukemia who developed CMV meningoencephalitis after cord blood transplantation. The patient presented with a sudden onset of neurological symptoms, such as convulsion, on day 37. The analysis of cerebrospinal fluid (CSF) sample revealed an increase in the number of cells, which were of donor (cord blood) origin, consisting mainly of T cells. No bacteria were detected in the CSF sample. Real-time PCR analysis revealed that the CSF sample was positive for CMV, but was negative for HHV-6, adenovirus, or BK virus. The patient was diagnosed with CMV meningoencephalitis and received cidofovir. His neurological symptoms were gradually improved and completely disappeared by day 60. CMV-specific dextramer-positive CD8+ T cells were detected in the peripheral blood and CSF samples, with the frequency being much higher in the CSF. To our knowledge, this is the first report on the appearance of CMV-specific T cells in CSF samples from a patient with CMV meningoencephalitis. Cord blood-derived CMV-specific T cells may develop early after transplantation, enter the intrathecal compartment, and likely contribute to the regulation of CMV-meningoencephalitis.

Keywords

Cytomegalovirus Viral encephalitis Cord blood transplantation Dextramer 

Notes

Acknowledgments

We thank the medical, nursing, and laboratory staff of the participating departments for their contributions. We are also grateful to Ms. Aya Yano and Ms. Kimiko Yamamoto for their excellent technical assistance.

Conflict of interest

The authors declare no competing financial interests.

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Copyright information

© The Japanese Society of Hematology 2012

Authors and Affiliations

  • Kazuhiro Ikegame
    • 1
  • Ruri Kato
    • 1
  • Tatsuya Fujioka
    • 1
  • Masaya Okada
    • 1
  • Katsuji Kaida
    • 1
  • Shinichi Ishii
    • 1
  • Satoshi Yoshihara
    • 1
  • Takayuki Inoue
    • 1
  • Kyoko Taniguchi
    • 1
  • Hiroya Tamaki
    • 1
  • Toshihiro Soma
    • 1
  • Hiroyasu Ogawa
    • 1
    Email author
  1. 1.Division of Hematology, Department of Internal MedicineHyogo Medical CollegeNishinomiyaJapan

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