Rapid salvage treatment with virus-specific T cells for therapy-resistant disease
M Uhlin, J Gertow, M Uzunel, M Okas… - Clinical Infectious …, 2012 - academic.oup.com
M Uhlin, J Gertow, M Uzunel, M Okas, S Berglund, E Watz, M Brune, P Ljungman…
Clinical Infectious Diseases, 2012•academic.oup.comBackground. Viral infections are major complications after allogeneic hematopoietic stem
cell transplantation (HSCT). During posttransplant immunosuppression the regular T-cell
control is compromised. Even if treatment strategies against infections caused by herpes
viruses such as cytomegalovirus, Epstein-Barr virus, and adenovirus have improved, the
mortality rate is still considerable. If primary antiviral therapy fails or cannot be tolerated,
adoptive therapy with virus-specific cytotoxic T cells (CTL) can be utilized. Methods. In this …
cell transplantation (HSCT). During posttransplant immunosuppression the regular T-cell
control is compromised. Even if treatment strategies against infections caused by herpes
viruses such as cytomegalovirus, Epstein-Barr virus, and adenovirus have improved, the
mortality rate is still considerable. If primary antiviral therapy fails or cannot be tolerated,
adoptive therapy with virus-specific cytotoxic T cells (CTL) can be utilized. Methods. In this …
Abstract
Background. Viral infections are major complications after allogeneic hematopoietic stem cell transplantation (HSCT). During posttransplant immunosuppression the regular T-cell control is compromised. Even if treatment strategies against infections caused by herpes viruses such as cytomegalovirus, Epstein-Barr virus, and adenovirus have improved, the mortality rate is still considerable. If primary antiviral therapy fails or cannot be tolerated, adoptive therapy with virus-specific cytotoxic T cells (CTL) can be utilized.
Methods. In this study, we used virus-specific CTLs to treat 8 patients suffering from severe viral infections after allogeneic HSCT. Using positive selection with HLA multimers and magnetic beads, we isolated CTLs from both frozen donor material as well as third-party donors within hours.
Results. At 90 days after CTL infusions 7 out of 8 patients were still living. CTLs infused from third-party donors were detected in 5 of 6 patients up to 76 days after infusion. No graft-versus-host disease associated with CTL infusions was observed.
Conclusions. Our separation approach offers a rapid alternative for adoptive CTL therapy if primary antiviral treatment strategies fail. Because no prolonged expansion steps are needed, this method may be used for early treatment of patients suffering from life-threatening infectious complications.
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