SUCCESSFUL BK VIRUS-SPECIFIC T CELLS THERAPY IN A KIDNEY TRANSPLANT RECIPIENT WITH PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY.

The strategy for Progressive Multifocal Leukoencephalopathy (PML) in Solid Organ Transplant recipients primarily focuses on reducing immunosuppressive therapy. However, this approach offers limited efficacy and carries a high risk of graft loss. Here, we present the case of a 64-year-old male kidney transplant recipient with a high degree of immunosuppression who developed PML in October 2022. Despite standard reduction of immunosuppressive therapy, the patient's condition continued to deteriorate, as evidenced by worsening neurological symptoms and increasing JC virus DNA levels in cerebrospinal fluid. This prompted the innovative use of BKPyV -specific T Cells-(BKPyV -VST) therapy, given the genetic similarities between BK and JC viruses. Infusion of third-party donor BKPyV -VST resulted in clinical stabilization, significant reduction in JCV DNA levels, and the emergence of a JC virus-specific T cell response, as observed in ELISpot assays and TCRβ sequencing. This represents the first case report of successful third-party BKPyV -VST -specific therapy in a kidney recipient presenting PML, without graft-versus-host disease or graft dysfunction.

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Copyright © 2024 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Marta Bodro reports article publishing charges was provided by Hospital Clínic de Barcelona. Marta Bodro reports a relationship with Hospital Clínic de Barcelona that includes: employment. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.