Viral infection in hematopoietic stem cell transplantation: an International Society for Cell & Gene Therapy Stem Cell Engineering Committee review on the role of cellular therapy in prevention and treatment.

Despite recent advances in the field of HSCT, viral infections remain a frequent causeof morbidity and mortality among HSCT recipients. Adoptive transfer of viral specific T cells has been successfully used both as prophylaxis and treatment of viral infections in immunocompromised HSCT recipients. Increasingly, precise risk stratification of HSCT recipients with infectious complications should incorporate not only pretransplant clinical criteria, but milestones of immune reconstitution as well. These factors can better identify those at highest risk of morbidity and mortality and identify a population of HSCT recipients in whom adoptive therapy with viral specific T cells should be considered for either prophylaxis or second line treatment early after inadequate response to first line antiviral therapy. Broadening these approaches to improve outcomes for transplant recipients in countries with limited resources is a major challenge. While the principles of risk stratification can be applied, early detection of viral reactivation as well as treatment is challenging in regions where commercial PCR assays and antiviral agents are not readily available.

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Copyright © 2022. Published by Elsevier Inc.

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Conflicts of Interest JJB reported consulting for Avrobio, BlueRock, Race Oncology, Advanced Clinical, Omeros, Sanofi, Medexus, Equillium, Sobi. AA served on the safety monitoring committee for Sangamo Therapeutics and has no financial interest in the development of gene therapies. SP received support for the conduct of clinical trials through MSK from AlloVir, Atara and Jasper; inventor of IP related to third-party viral specific T cells program with all rights assigned to MSK. CB reported consulting for Zodiac, Amgen and Novartis. SC reported royalties, consulting and shares for ExCellThera. DP reported honoraria paid to Fiona Stanley Hospital from Novartis, Gilead, BMS-Celgene and Jazz. AS reported consulting for Spotlight Therapeutics, Medexus Inc and Vertex Pharmaceuticals; research funding from CRISPR Therapeutics Research; collaboration with Magenta Therapeutics; honoraria from Vindico Medical Education; and Clinical Trial site-PI for CRISPR Therapeutics, Vertex Pharmaceuticals, Novartis and Magenta.