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.
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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.”
- 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]