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Patients with aGVHD (grate II�CIV) had more often early viral reactivations/infections than those without (42% versus 75%, P?selleck chemical of patients with both aGVHD and early viral reactivations/infections developed moderate/severe cGVHD after HSCT (P?CHIR99021 during the first 100?days after HSCT. Of the 20, 16 (80%) had multiple early viral infections, most often also including the detection of either BK-virus (7/20) or HHV-6 (7/20). CMV viremia was detected in 12/51 (24%) with all being seropositive prior to transplant. Of the 16 (75%) patients at a high risk of CMV (recipient seropositive and donor-negative), 12 received prophylactic acyclovir/ganciclovir. EBV viremia was detected by PCR in 4/51 (8%) patients, and all were seropositive prior to transplant. Adenovirus was detected in 8% (3/51) of the patients. Early viral selleck chemicals llc detection in blood associated during the first 100?days post-HSCT with enteritis (CMV 3/12, adenovirus 1/3), pneumonia (CMV 2/12, 1/3 adenovirus), encephalitis (EBV 1/4), cystitis (adenovirus 1/3) and/or viremia (CMV 7/12 and EBV 3/4). The absolute numbers of CD3+, CD4+ and CD8+ T cells and TRECs (Table?1 and Fig.?1) recovered more slowly among those with moderate/severe cGVHD when compared with those without. The occurrence of early viral (CMV, EBV or adenovirus) reactivations/infections associated with an impaired recovery process of naive T cells (Fig.?1) and low TRECs after HSCT (Fig.?1). The absolute counts of CD3+ and CD8+ T cells reached the 5th percentile of control values within 12?months after HSCT in about 70% of cases. Again, 70% of those with moderate to severe cGVHD had not normalized their CD3+ and CD8+ T counts by 12?months after transplant. The absolute counts of naive T cells reached the control values by 12?months in 67% of cases, while none with moderate/severe cGVHD had normalized their naive T cells by the end of the first post-transplant year (Fig.?1). The absolute numbers of CD19+ (Fig.?2) and CD20+ B cells recovered faster in children without than those with moderate/severe cGVHD. Also, the occurrence of early viral (CMV, EBV or adenovirus) reactivations/infections associated with an impaired recovery of B cells (P?