Successful treatment of CMV, EBV, and adenovirus tissue infection following HLA-mismatched allogeneic stem cell transplant using infusion of third-party T cells from multiple donors in addition to antivirals, rituximab, and surgery.
allogeneic stem cell transplant
cellular therapy
virus-specific T cells
Journal
Transplant infectious disease : an official journal of the Transplantation Society
ISSN: 1399-3062
Titre abrégé: Transpl Infect Dis
Pays: Denmark
ID NLM: 100883688
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
revised:
18
10
2020
received:
11
08
2020
accepted:
15
11
2020
pubmed:
26
11
2020
medline:
3
8
2021
entrez:
25
11
2020
Statut:
ppublish
Résumé
Viral infections, principally cytomegalovirus, Epstein Barr virus (EBV) and adenovirus, are a leading cause of morbidity and mortality after allogeneic stem cell transplantation. The use of systemic antivirals is limited by limited efficacy and organ toxicities. Inability to clear infection is exacerbated by transplant-related immunosuppression and prophylaxis or treatment of acute graft versus host disease. We report the first patient to clear three serious viral infections after stem cell transplant using third-party donor partially human leukocyte antigen (HLA) matched virus-specific cytotoxic T cells. The patient, a 53 year old female with transplanted for relapsed leukemia, with severe graft versus host disease received five T cell infusions from three separate donors that ultimately cleared serious systemic infections with cytomegalovirus and adenovirus, and an EBV-driven lymphoma. Systemic antivirals had resulted in failed clinical responses. Use of repeated infusions of partially HLA matched virus-specific T cells from banks containing cryopreserved cells should be strongly considered in transplant recipients with single or multiple refractory viral infections.
Substances chimiques
Antiviral Agents
0
HLA Antigens
0
Rituximab
4F4X42SYQ6
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13528Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
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