Successful treatment of EBV-associated posttransplantation lymphoma after cord blood transplantation using third-party EBV-specific cytotoxic T lymphocytes Journal Article

   

Authors:	Barker, J. N.; Doubrovina, E.; Sauter, C.; Jaroscak, J. J.; Perales, M. A.; Doubrovin, M.; Prockop, S. E.; Koehne, G.; O'Reilly, R. J.
Article Title:	Successful treatment of EBV-associated posttransplantation lymphoma after cord blood transplantation using third-party EBV-specific cytotoxic T lymphocytes
Abstract:	Cellular therapy of Epstein-Barr virus (EBV)+ posttransplantation lymphoproliferative diseases (PTLD) in cord blood transplant (CBT) recipients is limited by lack of donor access and the donor's naive neonatal immune system. We therefore used partially human leukocyte antigen-matched third-party in vitro expanded EBV-specific cytotoxic T lymphocytes (CTLs) to treat 2 CBT recipients with life-threatening, donor-derived monoclonal EBV+ diffuse large B-cell lymphomas with extranodal involvement developing in the context of graft-versus-host disease. Both patients had failed immunosuppression taper and Rituximab. After 5 and 9 infusions of 106 EBV-CTL/kg, respectively, each patient achieved a sustained complete remission without toxicity or graft-versus-host disease. Each is alive without recurrence at 20 and 15 months, respectively, post-EBV-PTLD diagnosis. This approach demonstrates the efficacy of using "off-the-shelf, " virus-specific third-party CTLs restricted by human leukocyte antigens expressed by the tumor to treat otherwise lethal EBV-PTLD. Such therapy may also be applicable to the treatment of other infections and residual or recurrent malignancy after CBT. © 2010 by The American Society of Hematology.
Keywords:	adult; child; school child; anamnesis; case report; rituximab; nuclear magnetic resonance imaging; cord blood stem cell transplantation; immunotherapy; cytotoxic t lymphocyte; t-lymphocytes, cytotoxic; lymphoma; graft versus host reaction; remission; lymphoproliferative disease; large cell lymphoma; lymphoma, large b-cell, diffuse; immunosuppressive treatment; graft vs host disease; leukocyte antigen; hla antigens; epstein barr virus; epstein-barr virus infections; posttransplant lymphoproliferative disease
Journal Title:	Blood
Volume:	116
Issue:	23
ISSN:	0006-4971
Publisher:	American Society of Hematology
Date Published:	2010-12-02
Start Page:	5045
End Page:	5049
Language:	English
DOI:	10.1182/blood-2010-04-281873
PUBMED:	20826724
PROVIDER:	scopus
PMCID:	PMC3012598
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-78049278080&partnerID=40&md5=3ded385363e13ab6faea1ddef4ca2014
Notes:	--- - "Cited By (since 1996): 3" - "Export Date: 20 April 2011" - "CODEN: BLOOA" - "Source: Scopus"

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