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HLA单倍型相合造血细胞移植后,BK病毒特异性T细胞在治疗严重难治性出血性膀胱炎中的应用

BKV-specific T cells in the treatment of severe refractory haemorrhagic cystitis after HLA-haploidentical haematopoietic cell transplantation.

作者信息

Pello Oscar M, Innes Andrew J, Bradshaw Anne, Finn Sally-Anne, Uddin Shab, Bray Emma, Olavarria Eduardo, Apperley Jane F, Pavlů Jiří

机构信息

Centre for Haematology, Imperial College at Hammersmith Hospital, London, UK.

出版信息

Eur J Haematol. 2017 Jun;98(6):632-634. doi: 10.1111/ejh.12848. Epub 2017 Mar 1.

Abstract

BACKGROUND

Haemorrhagic cystitis caused by BK virus (BKV) is a known complication of allogeneic haematopoietic cell transplantation (HCT) and is relatively common following HLA-haploidentical transplantation. Adoptive immunotransfer of virus-specific T cells from the donor is a promising therapeutic approach, although production of these cells is challenging, particularly when dealing with low-frequency T cells such as BKV-specific T cells.

CASE REPORT

Here, we present a patient who, following haploidentical HCT, developed severe BKV haemorrhagic cystitis, resistant to standard therapy. He responded well to adoptive transfer of donor cells enriched in BKV-specific T cells using the new second-generation CliniMACS Prodigy and the Cytokine Capture System from Miltenyi Biotec. Treatment led to full resolution of both the symptoms and viraemia without unwanted complications.

CONCLUSION

Our observations suggest that use of products enriched with BKV-specific T cells generated using this system is safe and efficient in HLA-haploidentical HCT where BKV cystitis can be a serious complication.

摘要

背景

BK病毒(BKV)引起的出血性膀胱炎是异基因造血细胞移植(HCT)的一种已知并发症,在HLA单倍型相合移植后相对常见。从供体进行病毒特异性T细胞的过继免疫转移是一种有前景的治疗方法,尽管这些细胞的产生具有挑战性,尤其是在处理低频T细胞(如BKV特异性T细胞)时。

病例报告

在此,我们介绍一名患者,其在单倍型相合HCT后发生了严重的BKV出血性膀胱炎,对标准治疗耐药。使用来自美天旎生物技术公司的新型第二代CliniMACS Prodigy和细胞因子捕获系统对富含BKV特异性T细胞的供体细胞进行过继转移后,他反应良好。治疗使症状和病毒血症完全消退,且无不良并发症。

结论

我们的观察结果表明,在BKV膀胱炎可能是严重并发症的HLA单倍型相合HCT中,使用该系统产生的富含BKV特异性T细胞的产品是安全有效的。

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