{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:09:03Z","timestamp":1777637343945,"version":"3.51.4"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009647","name":"Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Human cytomegalovirus (CMV) remains a major cause of morbidity and mortality in pediatric allogeneic hematopoietic stem cell transplantation (allo-HSCT), where its high genetic variability and the limitations of current antiviral therapies pose significant clinical challenges. Despite standard antiviral prophylaxis, CMV infection affects up to 80% of allo-HSCT recipients, necessitating the evaluation of alternative strategies to overcome the limitations of conventional treatments. This single-center ambispective study investigates the application of CMV-specific immunoglobulin (Ig) prophylaxis, focusing on its impact on viral clearance, transplant outcomes, immunological readouts, and efficacy across diverse ethnic cohorts (European vs. non-European).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A\n                      <jats:italic>post hoc<\/jats:italic>\n                      analysis was performed on 71 hematopoietic stem cell recipients who received CMV-specific Ig (Study Group) and historical controls (Control Group). A pharmacokinetic analysis was performed on the Study Group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Control Group exhibited higher rates of first-blood CMV DNA detection post-transplant (p = 0.0024), second-blood CMV DNA detection post-transplant (p = 0.00042), CMV DNA viral load (p = 0.0016), reduced hospital stays (p = 0.007) and improved immune reconstitution (p &amp;lt; 0.0001). No significant differences in hospital stay emerged between European and non-European patients. However, Europeans had better results in first-blood CMV DNA detection (p = 0.006), second reactivation (p = 0.00032), immune reconstitution at day +90 (p = 0.0443), clearance rates, and reduced need for second-line therapy (p &amp;lt; 0.001). The terminal half-life of CMV-specific Ig was approximately 15 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings demonstrate that CMV-specific Ig serves as an effective molecular immunotherapy, significantly improving immunological readouts and clinical outcomes in pediatric allo-HSCT. Furthermore, the observed ethnic disparities underscore the importance of personalized molecular strategies to address CMV genome variability and global health challenges.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1832716","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:07:33Z","timestamp":1777442853000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The diversity of cytomegalovirus among blood donors and transplant recipients could affect the effectiveness of specific anti-CMV immunoglobulins"],"prefix":"10.3389","volume":"17","author":[{"given":"Stefania","family":"Braidotti","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Institute for Maternal and Child Health - IRCCS \u201cBurlo Garofolo\u201d \u2013","place":["Trieste, 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