期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 137, 期 5, 页码 1498-+出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2015.12.1311
关键词
Primary immunodeficiency; immunotherapy; cytotoxic T lymphocytes; antiviral therapy
资金
- National Institutes of Health [RO1CA061384, P50CA126752, U54 HL081007]
- National Cancer Institute [PO1 CA148600e02]
- SPORE [5P50CA126752]
- SCOR from the Leukemia and Lymphoma Society
- Production Assistance for Cellular Therapies (PACT) program (NHLBI) [HHSN268201000007C]
- Clinical Research Center at Texas Children's Hospital
- Dan L. Duncan Institute for Clinical and Translational Research at Baylor College of Medicine
- Amy Strelzer Manasevit Scholar Award
- Clinical Immunology Society
- Jeffrey Modell Diagnostic and Research Center Grant
- American Academy of Allergy, Asthma Immunology
- American College of Allergy, Asthma Immunology
- Clinical and Translational Science Institute at Children's National
- Jeffrey Modell Foundation
- MRC [MR/K007491/1] Funding Source: UKRI
- Medical Research Council [MR/K007491/1] Funding Source: researchfish
Background: Viral infections are a leading fatal complication for patients with primary immunodeficiencies (PIDs) who require hematopoietic stem cell transplantation (HSCT). Use of virus-specific T lymphocytes (VSTs) has been successful for the treatment and prevention of viral infections after HSCT for malignant and nonmalignant conditions. Here we describe the clinical use of VSTs in patients with PIDs at 4 centers. Objective: We sought to evaluate the safety and efficacy of VSTs for treatment of viral infections in patients with PIDs. Methods: Patients with PIDs who have received VST therapy on previous or current protocols were reviewed in aggregate. Clinical information, including transplantation details, viral infections, and use of antiviral and immunosuppressive pharmacotherapy, were evaluated. Data regarding VST production, infusions, and adverse reactions were compared. Results: Thirty-six patients with 12 classes of PID diagnoses received 37 VST products before or after HSCT. Twenty-six (72%) patients had received a diagnosis of infection with cytomegalovirus, EBV, adenovirus, BK virus, and/or human herpesvirus 6. Two patients were treated before HSCT because of EBV-associated lymphoproliferative disease. Partial or complete responses against targeted viruses occurred in 81% of patients overall. Time to response varied from 2 weeks to 3 months ( median, 28 days). Overall survival at 6 months after therapy was 80%. Four patients had graft-versus-host disease in the 45 days after VST infusion, which in most cases was therapy responsive. Conclusion: VSTs derived from either stem cell donors or third-party donors are likely safe and effective for the treatment of viral infections in patients with PIDs.
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