Assessment of the potential value of plasma Torque Teno virus DNA load
monitoring to predict Cytomegalovirus DNAemia in patients with
hematological malignancies treated with small molecule inhibitors: A
proof-of-concept study
Abstract
Background: It is unknown whether Torque Teno virus (TTV) DNA
load monitoring could anticipate the development of infectious events in
hematological patients undergoing treatment with small molecular
targeting agents. We characterized the kinetics of plasma TTV DNA in
patients treated with ibrutinib or ruxolitinib and assessed whether TTV
DNA load monitoring could predict the occurrence of Cytomegalovirus
(CMV) DNAemia or the magnitude of CMV-specific T-cell responses.
Methods: Multicenter, retrospective, observational study,
recruiting 20 patients treated with ibrutinib and 21 with ruxolitinib.
Plasma TTV and CMV DNA loads were quantified by real-time PCR at
baseline and days +15, +30, +45, +60, +75, +90, +120, +150, and +180
after treatment inception. Enumeration of CMV-specific IFN-γ-producing
CD8 + and CD4 + T cells in whole
blood was performed by flow cytometry. Results: Median TTV DNA
load in ibrutinib-treated patients increased significantly (
P=0.025) from baseline (median, 5.76 log 10
copies/ml) to day +120 (median, 7.83 log 10 copies/ml).
A moderate inverse correlation (Rho=-0.46; P<0.001) was
found between TTV DNA load and absolute lymphocyte count (ALC). In
ruxolitinib-treated patients, TTV DNA load quantified at baseline was
not significantly different from that measured after treatment inception
( P ≥0.12). TTV DNA loads were not predictive of the subsequent
occurrence of CMV DNAemia in either patient group. No correlation was
observed between TTV DNA loads and CMV-specific IFN-γ-producing CD8
+ and CD4 + T cell counts in either
patient group. Conclusion: The data did not support the
hypothesis that TTV DNA load monitoring in hematological patients
treated with ibrutinib or ruxolitinib could be useful to predict either
the occurrence of CMV DNAemia or the level of CMV-specific
reconstitution.