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Mixed T-Cell Chimerism Following Hematopoietic Cell Transplantation for Non-Malignant Disorders Is Common, Facilitates Anti-Viral Immunity, and Is Not Associated with Graft Failure in Pediatric Patients.
Cells
December 2024
Departments of Blood and Marrow Transplant, Royal Manchester Children's Hospital, Manchester M13 9WL, UK.
Myeloid chimerism better reflects donor stem cell engraftment than whole-blood chimerism in assessing graft function following allogeneic hematopoietic stem cell transplant (HCT). We describe our experience with 130 patients aged younger than 18 years, treated with allogeneic HCT using bone marrow or PBSC from HLA-matched donors for non-malignant diseases, whose pre-transplant conditioning therapy included alemtuzumab and who were monitored with lineage-specific chimerism after transplant. At 6 years post-transplant, overall survival (OS) was 91.
View Article and Find Full Text PDFCompassionate access to virus-specific T cells for adoptive immunotherapy over 15 years.
Nat Commun
December 2024
Queensland Immunology Research Centre, Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
Adoptive T-cell immunotherapy holds great promise for the treatment of viral complications in immunocompromised patients resistant to standard anti-viral strategies. We present a retrospective analysis of 78 patients from 19 hospitals across Australia and New Zealand, treated over the last 15 years with "off-the-shelf" allogeneic T cells directed to a combination of Epstein-Barr virus (EBV), cytomegalovirus (CMV), BK polyomavirus (BKV), John Cunningham virus (JCV) and/or adenovirus (AdV) under the Australian Therapeutic Goods Administration's Special Access Scheme. Most patients had severe post-transplant viral complications, including drug-resistant end-organ CMV disease, BKV-associated haemorrhagic cystitis and EBV-driven post-transplant lymphoproliferative disorder.
View Article and Find Full Text PDFCurrent and future strategies for the prevention and treatment of cytomegalovirus infections in transplantation.
Clin Infect Dis
November 2024
Division of Allergy and Infectious Diseases Division, Department of Medicine, University of Washington, Seattle, WA, USA.
Article Synopsis
- - Recent advancements in cytomegalovirus (CMV) prevention and treatment have emerged from pivotal clinical trials, focusing on tailored strategies for hematopoietic cell transplantation (HCT) and solid organ transplantation (SOT).
- - The review highlights methods to boost CMV-specific immunity using vaccination, monoclonal antibodies, and virus-specific T-cells, alongside observational studies on CMV cell-mediated immunity assays to refine preventive and treatment approaches.
- - Emphasizing the need to enhance CMV-specific immunity is vital for reducing CMV's detrimental effects in transplant recipients, especially as infections in CAR-T therapy patients and other immunocompromised groups rise, although these areas are not covered in this review.
Cytomegalovirus in haematopoietic cell transplantation - The troll is still there.
Best Pract Res Clin Haematol
September 2024
Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. Electronic address:
Patients undergoing allogeneic haematopoietic cell transplantation are prone to complications caused by viral infections. Cytomegalovirus (CMV) considerably impacts transplantation as it frequently requires antiviral intervention that evokes substantial side effects depending on the antiviral drug. Intermittent antiviral treatment may become necessary if CMV DNAemia cannot be permanently suppressed, and drug resistance may emerge that hampers and prolongs treatment.
View Article and Find Full Text PDFDirectly Isolated Allogeneic Virus-Specific T Cells in Progressive Multifocal Leukoencephalopathy.
JAMA Neurol
October 2024
Department of Neurology, Hannover Medical School, Hannover, Germany.
Article Synopsis
- Progressive multifocal leukoencephalopathy (PML) is a severe viral infection without any approved antiviral treatments, making effective management crucial.
- A study tested a novel treatment approach using directly isolated allogeneic virus-specific (DIAVIS) T cells in 28 patients with PML, showing substantial clinical improvements in 79% of cases.
- The main findings indicate that DIAVIS T cell therapy can stabilize or improve patients' conditions and lower viral loads, although those older in age had worse outcomes, and some patients still experienced rapid deterioration.
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