Intensive immunosuppression associated with loss of HCMV-specific T-cell responses and late HCMV disease.

Peptide-specific CD8⁺ and protein-specific CD4⁺T cells were analyzed by intracellular IFN-γ staining with flow cytometry after specific stimulation. Black bars indicate HLA-A*0201–restricted CTLs and gray bars HCMV-specific CD4⁺ T cells. This patient (15 on Table 2) received donor lymphocytes for relapse of the underlying malignant disease, and severe GVHD subsequently developed. Intensive immunosuppression with prednisolone (Pred) and OKT3 was associated with complete ablation of HCMV-specific T-cell responses and subsequent onset of fatal HCMV disease.