T-cell depleted allogeneic hematopoietic cell transplants as a platform for adoptive therapy with leukemia selective or virus-specific T-cells. Review uri icon

Overview

abstract

  • Allogeneic hematopoietic cell transplants adequately depleted of T-cells can reduce or prevent acute and chronic GVHD in both HLA-matched and haplotype-disparate hosts, without post-transplant prophylaxis with immunosuppressive drugs. Recent trials indicate that high doses of CD34+ progenitors from G-CSF mobilized peripheral blood leukocytes isolated and T-cell depleted by immunoadsorption to paramagnetic beads, when administered after myeloablative conditioning with TBI and chemotherapy or chemotherapy alone can secure consistent engraftment and abrogate GVHD in patients with acute leukemia without incurring an increased risk of a recurrent leukemia. Early clinical trials also indicate that high doses of in vitro generated leukemia-reactive donor T-cells can be adoptively transferred and can induce remissions of leukemia relapse without GVHD. Similarly, virus-specific T-cells generated from the transplant donor or an HLA partially matched third party, have induced remissions of Rituxan-refractory EBV lymphomas and can clear CMV disease or viremia persisting despite antiviral therapy in a high proportion of cases. Analyses of treatment responses and failures illustrate both the advantages and limitations of donor or banked, third party-derived T-cells, but underscore the potential of adoptive T-cell therapy in the absence of ongoing immunosuppression.

publication date

  • June 1, 2015

Research

keywords

  • Adoptive Transfer
  • Epstein-Barr Virus Infections
  • Graft vs Host Disease
  • Hematopoietic Stem Cell Transplantation
  • Herpesvirus 4, Human
  • Leukemia
  • Lymphocyte Depletion
  • T-Lymphocytes
  • Transplantation Conditioning

Identity

PubMed Central ID

  • PMC4787269

Scopus Document Identifier

  • 84930428303

Digital Object Identifier (DOI)

  • 10.1016/j.bbmt.2013.12.049

PubMed ID

  • 26039207

Additional Document Info

volume

  • 50 Suppl 2

issue

  • Suppl 2