Virus-specific T cells Effective for Infection Post-HSCT

Virus-specific T cell (VST) infusions may be an effective treatment for severe and drug-refractory infections in patients who receive allogeneic hematopoietic stem cell transplantation (HSCT), according to a study published in the Journal of Clinical Oncology.¹

VSTs are promising for the treatment of Epstein-Barr virus (EBV), cytomegalovirus (CMV) and adenovirus (AdV), but the cost, time needed for production, manufacturing complexity, and need for seropositive donors prevent widespread utilization.

For this phase 2 study, 59 VST lines were manufactured and banked for EBV, CMV, AdV, human herpesvirus 6 (HHV-6), and the BK virus (BKV).

Researchers treated 38 patients who underwent HSCT and were infected with at least 1 of these viruses; 31 were treated for a single viral infection and 7 were treated for 2 viral infections.

Patients who received a single infusion achieved a cumulative complete or partial response rate of 92% (95% CI, 78.1%-98.3%), with 100% for BKV, 100% for EBV, 94% for CMV, 71% for AdV, and 67% for HHV-6. All patients experienced clinical benefit.

VST infusions were well-tolerated by patients, with only 2 cases of de novo grade 1 graft-vs-host disease (GVHD) reported.

The treatment was confirmed to be effective up to 12 weeks after initial administration.

The authors concluded that “more widespread and earlier use of this modality could minimize both drug-related and virus-associated complications and thereby decrease treatment-related mortality in recipients of allogeneic HSCT.”

Reference

1. Tzannou I, Papadopoulou A, Naik S, et al. Off-the-shelf virus-specific T cells to treat BK virus, human herpesvirus 6, cytomegalovirus, Epstein-Barr virus, and adenovirus infections after allogeneic hematopoietic stem-cell transplantation. 2017 Aug 7. J Clin Oncol. doi: 10.1200/JCO.2017.73.0655 [Epub ahead of print]