Nearly three fourths of transplant patients with refractory infections responded to treatment with banked, virus-specific T-cells.

Epstein-Barr virus (EBV), cytomegalovirus (CMV), and adenovirus (ADV) infections are often life threatening in immunocompromised patients who undergo hematopoietic stem cell transplantation. When these infections in such patients become refractory to commonly used antiviral drugs, infusion of virus-specific T-cells might be beneficial.

To explore this approach, investigators prepared 32 virus-specific cell lines from donors who were immune to EBV, CMV, or ADV. Selected cells were infused in 50 recipients with infections that had persisted for 7 days despite standard therapy. Human leukocyte antigen matching was performed to confirm that the cells chosen for infusion had antiviral activity against the specific infecting virus.

At 6 weeks, the cumulative rate of complete or partial response in all patients was 74.0% (95% confidence interval; 58.5–89.5); response rates for patients with EBV, CMV, and ADV infections were 66.7%, 73.9%, and 77.8%, respectively. Studies of four responders showed that donor-derived T-cell sequences appeared coincidently with the reduction in viral load. Only 4 of the 37 responders (11%) experienced subsequent progression or recurrence of the original infection. All infusions were well tolerated, serious adverse reactions were infrequent, and only two patients developed de novo graft-versus-host disease.

CITATION(S):

Leen AM et al. Multicenter study of banked third party virus-specific T-cells to treat severe viral infections after hematopoietic stem cell transplantation. Blood 2013 Apr 22; [e-pub ahead of print].