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. 2019 Dec 26;106(2):363–374. doi: 10.3324/haematol.2019.229252

Figure 3.

Figure 3.

Legend on following page. Performance of cytomegalovirus (CMV) cell-mediated immunity measured around day 100 after hematopoietic stem cell transplantation to predict freedom from and occurrence of late recurrent CMV reactivation (post-hoc). (A) Interferon-γ enzyme-linked immunospot (ELISpot) tests performed between day 80 (d80) and day 100 (d100) after hematopoietic stem cell transplantation in patients with an earlier CMV reactivation were used for the analysis. In the case that several measurement were available, the one closest to day 100 was considered. (B) Quantitative ELISpot results in response to CMV IE-1 and pp65 proteins were evaluated as detailed in the legend to Figure 2. Differences in spot-forming cell (SFC) distribution between patients with a CMV reactivation before day 100 only and those with a late (after day 100) recurrent CMV reactivation were evaluated using a Mann-Whitney U test. The median and interquartile range of the squared mean of square-root-transformed (SRM^2) SFC are shown above each graph. Additional information (minimum, maximum, 10th and 90th percentiles) are shown in Online Supplementary Table S4. Due to the log scale representation, values of zero SRM^2 were replaced by 0.01 (y-axis), meaning that baseline values shown at y=0.01 are actually equal to zero. Red triangles and blue dots represent negative and positive tests, respectively, defined according to the rules described in the Online Supplementary Methods. (C) Prediction of late recurrent CMV reactivation based on IE-1- and pp65-specific SFC counts measured around day 100 was evaluated by receiver operating characteristic curve analysis, as detailed in the legend to Figure 2. (D) Cumulative incidence of recurrent CMV reactivation based on IE- 1- and pp65-specific qualitative test results around day 100, was evaluated as detailed in the legend to Figure 2. Median (range) follow up time after T-TrackR CMV measurement was 132 (59-145) days in (censored) patients with no documented late recurrent CMV reactivation. The median (range) time to late recurrent CMV reactivation after T-TrackR CMV measurement was 119 (105-165) days. Moreover, the last recurrent CMV event in the case of a pp65- (and T-TrackR CMV)-positive test result occurred 31 days after the day-100 measurement, compared to 77 days in the case of a pp65- and IE-1-negative test result. CMI: cell-mediated immunity; HSCT: hematopoietic stem cell transplantation; IQR: interquartile range; MWU: Mann-Whitney U test; D-/R+: CMV-negative donor/CMV-positive recipient; AUC: area under curve; 95% CI: 95% confidence interval; HR: hazard ratio.