Outcomes after Third Party, Viral-Specific, Cytotoxic Lymphocytes for Immunosuppression- and Epstein-Barr Virus-Associated Lymphoproliferative Disease

Epstein-Barr virus associated lymphoproliferative disease is a serious complication of immunosuppression, particularly after transplantation. Initial treatments usually comprise reduction of immunosuppression, rituximab and/or chemotherapy. However, some patients fail to respond or are unsuitable for chemotherapy and so are candidates for adoptive cellular therapy. Here we report outcomes from the use of a bank of 25 third party derived Epstein-Barr virus specific lymphocyte cell lines cryopreserved for immediate use, issued on a best-HLA match basis. Cells have been issued to 70 patients. The infusions were well tolerated, although in two patients, evidence of mild, transient, cutaneous GVHD was observed, both treated with topical agents. In one patient, there was a temporary worsening of neurological symptoms, thought to represent a tumour flare in a patient who responded. 59 patients have received cells with a follow up of >6 months, 34 (58%) male and 25 (42%) female. The median age was 31 years (range 1 - 82). 48 patients had received transplants, 28 HSCT and 20 solid organs. All HSCT patients had received transplants from unrelated donors. SOT types were as follows: kidney, 10; liver, 3; heart, 2; bowel, 1; liver, small bowel and pancreas, 1; combined liver and kidney, 1; combined kidney and pancreas, 1; heart and kidney, 1. Eleven patients were immune suppressed due to causes other than transplantation: five with congenital immunodeficiencies, two on maintenance for ...
Source: Blood - Category: Hematology Authors: Tags: 703. Adoptive Immunotherapy: Poster II Source Type: research