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Treatment of a patient with severe cytomegalovirus (CMV) infection after haploidentical stem cell transplantation with donor derived CMV specific T cells.

Authors
  • Ingels, Joline1, 2
  • De Smet, Saskia2
  • Heyns, Kelly3
  • Lootens, Nele2
  • Segaert, Jonas4
  • Taghon, Tom1
  • Leclercq, Georges1
  • Vermaelen, Karim3
  • Willems, Evelyne5
  • Baudoux, Etienne5
  • Kerre, Tessa1, 4
  • Baron, Frédéric5
  • Vandekerckhove, Bart1, 2
  • 1 Department of Diagnostic Sciences, Ghent University, Ghent, Belgium. , (Belgium)
  • 2 Cell Therapy Unit, Department of Regenerative Medicine, Ghent University Hospital, Ghent, Belgium. , (Belgium)
  • 3 Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium. , (Belgium)
  • 4 Department of Internal Medicine, Ghent University Hospital, Ghent, Belgium. , (Belgium)
  • 5 Department of Medicine, Division of Hematology, University of Liège, Liège, Belgium. , (Belgium)
Type
Published Article
Journal
Acta clinica Belgica
Publication Date
Dec 01, 2021
Volume
76
Issue
6
Pages
482–486
Identifiers
DOI: 10.1080/17843286.2020.1752446
PMID: 32285755
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Objectives: Cytomegalovirus (CMV) infection is one of the most common complications in allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients. The classic antiviral treatments have shown clinical efficacy but are often associated with drug resistance. Reconstitution of CMV-specific cellular immunity is essential in controlling CMV infection; therefore, adoptive transfer of CMV-specific T cells is a promising treatment option. We treated a patient with a multidrug resistant CMV infection after haploidentical HSCT with CMV-specific T cells.Methods: The T cells were derived from the HSCT donor who was CMV seropositive. We generated the T cells by a short-term Good Manufacturing Practice (GMP) grade protocol in which a leukapheresis product of the HSCT donor was stimulated with the immunodominant antigen pp65 and interferon-γ secreting cells were isolated. A total of 5 × 105 T cells were administered to the patient within 30 hours after leukapheresis.Results: The patient was closely monitored for reconstitution of antiviral T cell immunity and viral replication after adoptive T cell transfer. We observed an in vivo expansion of both CD4+ and CD8+ CMV-specific T cells associated with a significant decrease in viral burden and clinical improvement.Conclusion: This case report further supports the feasibility and effectiveness of adoptive donor T cell transfer for the treatment of drug resistant CMV infections after allo-HSCT.

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