ArticleFrontiers in immunology2026
The diversity of cytomegalovirus among blood donors and transplant recipients could affect the effectiveness of specific anti-CMV immunoglobulins.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Human cytomegalovirus (CMV) remains a major cause of morbidity and mortality in pediatric allogeneic hematopoietic stem cell transplantation (allo-HSCT), where its high genetic variability and the limitations of current antiviral therapies pose significant clinical challenges. Despite standard antiviral prophylaxis, CMV infection affects up to 80% of allo-HSCT recipients, necessitating the evaluation of alternative strategies to overcome the limitations of conventional treatments. This single-center ambispective study investigates the application of CMV-specific immunoglobulin (Ig) prophylaxis, focusing on its impact on viral clearance, transplant outcomes, immunological readouts, and efficacy across diverse ethnic cohorts (European vs. non-European). Methods: A Results: The Control Group exhibited higher rates of first-blood CMV DNA detection post-transplant (p = 0.0024), second-blood CMV DNA detection post-transplant (p = 0.00042), CMV DNA viral load (p = 0.0016), reduced hospital stays (p = 0.007) and improved immune reconstitution (p < 0.0001). No significant differences in hospital stay emerged between European and non-European patients. However, Europeans had better results in first-blood CMV DNA detection (p = 0.006), second reactivation (p = 0.00032), immune reconstitution at day +90 (p = 0.0443), clearance rates, and reduced need for second-line therapy (p < 0.001). The terminal half-life of CMV-specific Ig was approximately 15 days. Discussion: These findings demonstrate that CMV-specific Ig serves as an effective molecular immunotherapy, significantly improving immunological readouts and clinical outcomes in pediatric allo-HSCT. Furthermore, the observed ethnic disparities underscore the importance of personalized molecular strategies to address CMV genome variability and global health challenges.
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