Survival after bone marrow transplantation from cytomegalovirus seropositive sibling donors

HLA-A2-restricted T cells show peptide-specific activity against cytomegalo virus and leukaemia cells. We retrospectively analysed the Influence of don or cytomegalovirus serostatus on the outcome of 103 consecutive patients wh o had leukaemia and who received bone-marrow transplants from HLA-identical sibling donors. We found that donor cytomegalovirus seropositivity signifi cantly improved overall survival (p = 0.02) as a result of lower relapse In cidence (p = 0.035) In HLA-A2-positive but not HLA-A2-negative recipients. In HLA-A2-positive recipients donor cytomegalovirus seropositivity was asso ciated with chronic graft-versus-host disease (GVHD), but even In patients without chronic GVHD donor cytomegalovirus seropositivity significantly imp roved survival (p = 0.0483). These preliminary data provide evidence that a t least In HLA-A2-positive recipients, transplantation of bone marrow from cytomegalovirus positive, HLA-identical sibling donors seems to be associat ed with substantial graft-versus-leukaemia activity, and suggests a cross-r eactivity of cytomegalovirus-specific donor-derived cytotoxic T cells with HLA-A2-restricted recipient minor histocompatibility antigens.