Jiang W, Clancy LE, Avdic S, et al. Third-Party CMV- and EBV-Specific T Cells for First Viral Reactivation After Allogeneic Stem Cell Transplant. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2022007103).
Third-party virus-specific T cells (VST) appears safe and results in high rate of viral control and excellent outcomes allogeneic stem cell transplant (HSCT) recipients. Researchers administered third-party VST in conjunction with antiviral therapy in patients being treated for their first cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infection. Overall, 30 HSCT patients (27 with CMV and 3 with EBV) received 1-4 VST infusions an average of 4 days after starting antiviral treatment. The overall viral response and complete response (CR) rates were 100% and 94%, respectively. Nine of the 28 patients who achieved a CR remained virus polymerase chain reaction (PCR) negative during follow up, while 14 were below the quantitation limit. Four patients experienced short bouts of quantifiable reactivation that required no additional treatment, while one patient needed a second infusion following initial CR and then remained PCR negative. The 3 patients who had EBV post-transplant lymphoproliferative disease had sustained CR. The overall rates of acute and chronic graft-versus-host-disease following infusion were 13% and 23%, respectively. No severe infusion-related adverse events were observed. The results correlated virological clearance with recovery of virus-specific immunity, especially CD8+ cells. Non-relapse mortality at 1 year post-HSCT was 10%, while the cumulative incidence of relapse was 7%, overall survival was 88%, and 25 of 27 patients had Eastern Cooperative Oncology Group scores of 0 or 1.