Cytotoxic T lymphocyte therapy with donor T cells prevents and treats adenovirus and Epstein-Barr virus infections after haploidentical and matched unrelated stem …

AM Leen, A Christin, GD Myers, H Liu… - Blood, The Journal …, 2009 - ashpublications.org
AM Leen, A Christin, GD Myers, H Liu, CR Cruz, PJ Hanley, AA Kennedy-Nasser, KS Leung…
Blood, The Journal of the American Society of Hematology, 2009ashpublications.org
Viral infection or reactivation remains a major cause of morbidity and mortality after
allogeneic stem cell transplantation. We now show that infusions of single cytotoxic T
lymphocyte (CTL) lines (5× 106-1.35× 108 cells/m2) with specificity for 2 commonly detected
viruses, Epstein-Barr virus (EBV) and adenovirus, can be safely administered to pediatric
transplantation recipients receiving partially human leukocyte antigen–matched and
haploidentical stem cell grafts (n= 13), without inducing graft-versus-host disease. The EBV …
Abstract
Viral infection or reactivation remains a major cause of morbidity and mortality after allogeneic stem cell transplantation. We now show that infusions of single cytotoxic T lymphocyte (CTL) lines (5 × 106-1.35 × 108 cells/m2) with specificity for 2 commonly detected viruses, Epstein-Barr virus (EBV) and adenovirus, can be safely administered to pediatric transplantation recipients receiving partially human leukocyte antigen–matched and haploidentical stem cell grafts (n = 13), without inducing graft-versus-host disease. The EBV-specific component of the CTLs expanded in vivo and persisted for more than 12 weeks, but the adenovirus-specific component only expanded in vivo in the presence of concomitant adenoviral infection. Nevertheless, adenovirus-specific T cells could be detected for at least 8 weeks in peripheral blood, even in CTL recipients without viral infection, provided the adenovirus-specific component of their circulating lymphocytes was first expanded by exposure to adenoviral antigens ex vivo. After infusion, none of these 13 high-risk recipients developed EBV-associated lymphoproliferative disease, while 2 of the subjects had resolution of their adenoviral disease. Hence, bispecific CTLs containing both EBV- and adenovirus-specific T cells can safely reconstitute an antigen responsive “memory” population of CTLs after human leukocyte antigen–mismatched stem cell transplantation and may provide antiviral activity. This trial was registered at www.clinicaltrials.gov as #NCT00590083.
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