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Clinical manifestations of <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> disease include graft dysfunction and failure in renal transplant recipients; <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content> recipients frequently experience hematuria, cystitis, hemorrhagic cystitis (<jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>), and renal dysfunction. Studies of <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content> patients have identified several risk factors for the development of <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> disease including myeloablative conditioning, acute graft\u2010versus\u2010host disease, and undergoing an umbilical cord blood (u<jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content>. Although these risk factors indicate that alterations in the immune system are necessary for <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> pathogenesis in <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content> patients, few studies have examined the interactions between host immune responses and viral reactivation in <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> disease. Specifically, having <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> immunoglobulin\u2010G before <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content> does not protect against <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> infection and disease after <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content>. A limited number of studies have demonstrated <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content>\u2010specific cytotoxic T cells in healthy adults as well as in post\u2010<jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content> patients who had experienced <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>. New areas of research are required for a better understanding of this emerging infectious disease post <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content>, including prospective studies examining <jats:styled-content style=\"fixed-case\">BK<\/jats:styled-content> viruria, viremia, and their relationship with clinical disease, a detailed analysis of urothelial histopathology, and laboratory evaluation of systemic and local cellular and humoral immune responses to <jats:styled-content style=\"fixed-case\">BKV<\/jats:styled-content> in patients receiving <jats:styled-content style=\"fixed-case\">HCT<\/jats:styled-content> from different sources, including u<jats:styled-content style=\"fixed-case\">CB<\/jats:styled-content> and haploidentical donors.<\/jats:p>","DOI":"10.1111\/tid.12233","type":"journal-article","created":{"date-parts":[[2014,5,19]],"date-time":"2014-05-19T06:02:07Z","timestamp":1400479327000},"page":"521-531","source":"Crossref","is-referenced-by-count":20,"title":["The polyomavirus puzzle: is host immune response beneficial in controlling <scp>BK<\/scp> virus after adult hematopoietic cell transplantion?"],"prefix":"10.1111","volume":"16","author":[{"given":"G.","family":"Satyanarayana","sequence":"first","affiliation":[{"name":"Division of Infectious Disease Department of Medicine, Brigham and Women's Hospital Boston Massachusetts USA"},{"name":"Division of Infectious Disease Department of Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston Massachusetts USA"},{"name":"Center for Virology and Vaccine Research Department of Medicine Beth Israel Deaconess Medical Center Harvard Medical School Boston Massachusetts 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