Transient Epstein-Barr virus reactivation in CD3 monoclonal antibody-treated patients

B Keymeulen, S Candon, S Fafi-Kremer… - Blood, The Journal …, 2010 - ashpublications.org
B Keymeulen, S Candon, S Fafi-Kremer, A Ziegler, M Leruez-Ville, C Mathieu
Blood, The Journal of the American Society of Hematology, 2010ashpublications.org
Here we report a unique situation in which an early and synchronized Epstein-Barr virus
(EBV) reactivation was induced by a 6-day course of treatment with a humanized CD3-
specific monoclonal antibody in patients with recent onset of type 1 diabetes. The virologic
and immunologic analysis demonstrated that this reactivation was transient, self-limited, and
isolated, associated with the rapid advent of an EBV-specific T-cell response. The anti-CD3
antibody administration induced short-lasting immunosuppression and minor yet clear-cut …
Abstract
Here we report a unique situation in which an early and synchronized Epstein-Barr virus (EBV) reactivation was induced by a 6-day course of treatment with a humanized CD3-specific monoclonal antibody in patients with recent onset of type 1 diabetes. The virologic and immunologic analysis demonstrated that this reactivation was transient, self-limited, and isolated, associated with the rapid advent of an EBV-specific T-cell response. The anti-CD3 antibody administration induced short-lasting immunosuppression and minor yet clear-cut signs of T-cell activation that preceded viral reactivation. Early posttransplant monitoring of renal and islet allograft recipients showed that no comparable phenomenon was observed after the administration of full-dose immunosuppressive therapy. This EBV reactivation remains of no apparent clinical concern over the long term and should not preclude further development of therapeutic anti-CD3 antibodies. This phenomenon may also direct new research avenues to understand the still ill-defined nature of stimuli triggering EBV reactivation in vivo.
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