Document Detail


Allogeneic cytotoxic T-cell therapy for EBV-positive posttransplantation lymphoproliferative disease: results of a phase 2 multicenter clinical trial.
MedLine Citation:
PMID:  17468341     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present the results of a multicenter clinical trial using Epstein-Barr virus (EBV)-specific cytotoxic T lymphocytes (CTLs) generated from EBV-seropositive blood donors to treat patients with EBV-positive posttransplantation lymphoproliferative disease (PTLD) on the basis of the best HLA match and specific in vitro cytotoxicity. Thirty-three PTLD patients who had failed on conventional therapy were enrolled. No adverse effects of CTL infusions were observed and the response rate (complete or partial) in 33 patients was 64% at 5 weeks and 52% at 6 months. Fourteen patients achieved a complete remission, 3 showed a partial response, and 16 had no response at 6 months (5 died before completing treatment). At 5 weeks, there was a significant trend toward better responses with higher numbers of CD4(+) cells in infused CTL lines (P = .001) that were maintained at 6 months (P = .001). Patients receiving CTLs with closer HLA matching responded better at 6 months (P = .048). Female patients responded better than male patients, but the differences were not statistically significant. Our results show that allogeneic CTLs are a safe and rapid therapy for PTLD, bypassing the need to grow CTLs for individual patients. The response rate in this poor prognosis patient group is encouraging.
Authors:
Tanzina Haque; Gwen M Wilkie; Marie M Jones; Craig D Higgins; Gillian Urquhart; Phoebe Wingate; David Burns; Karen McAulay; Marc Turner; Christopher Bellamy; Peter L Amlot; Deirdre Kelly; Alastair MacGilchrist; Maher K Gandhi; Anthony J Swerdlow; Dorothy H Crawford
Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2007-04-27
Journal Detail:
Title:  Blood     Volume:  110     ISSN:  0006-4971     ISO Abbreviation:  Blood     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-06     Completed Date:  2007-09-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1123-31     Citation Subset:  AIM; IM    
Affiliation:
Clinical and Molecular Virology Laboratory, University of Edinburgh, Edinburgh, United Kingdom. t.haque@medsch.ucl.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Antibodies, Viral / blood
Case-Control Studies
Child
Child, Preschool
Epstein-Barr Virus Infections / therapy*,  virology
Female
HLA Antigens / immunology
Herpesvirus 4, Human / immunology*
Humans
Immunotherapy
Immunotherapy, Adoptive
Infant
Lymphoproliferative Disorders / therapy*,  virology
Male
Middle Aged
Organ Transplantation
Polymerase Chain Reaction
T-Lymphocytes, Cytotoxic / transplantation*
Transplantation Immunology
Transplantation, Homologous
Chemical
Reg. No./Substance:
0/Antibodies, Viral; 0/HLA Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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