Treatment of a patient with severe cytomegalovirus (CMV) infection after haploidentical stem cell transplantation with donor derived CMV specific T cells

Abstract

Vandekerckhove (2020): Treatment of a patient with severe cytomegalovirus (CMV) infection after haploidentical stem cell transplantation with donor-derived CMV-specific T cells, Acta Clinica Belgica,

Donor-derived cytomegalovirus-cytotoxic T lymphocytes and leflunomide successfully control refractory cytomegalovirus infections and disease of multiple sites after allogeneic-hematopoietic stem cell transplantation: A case report

“…They attack CMV-infected cells to stop CMV amplification through direct cytolysis and indirect cell death, by releasing perforin/granzyme. Until recently, several studies have verified that donor-derived CMV-CTLs can overcome 10.3389/fmed.2022.948210 drug resistance of CMV after HSCT (2,4,5). In addition, limited case reports disclose that CMV-CTLs in the blood can efficiently eliminate CMV inside the oculus and CNS, even though separated by BBB and blood-ocular barrier (8,12).…”

“…The cause of a refractory infection can be due to either genetic or non-genetic mechanisms. Donor-derived CMV-specific cytotoxic T lymphocytes (CMV-CTLs) facilitate a completely different approach than traditional anti-CMV drugs and are thus a good choice for any mechanism of resistance while supporting a patient to quickly reacquire immunity against CMV, even under immunosuppressive conditions after HSCT (3)(4)(5). As a high dose of corticosteroid often contributes to the failure of such therapy (6,7), a question has arisen about what is the maximal level of corticosteroid, which might have less to no effect on CMV-CTLs?…”