Roddie Claire, Peggs Karl S
Department of Haematology, University College London Cancer Institute, London, United Kingdom.
Department of Haematology, University College London Hospitals NHS Foundation Trust, London, United Kingdom.
J Clin Invest. 2017 Jun 30;127(7):2513-2522. doi: 10.1172/JCI90599. Epub 2017 Jun 19.
Cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections following allogeneic hematopoietic stem cell transplantation (HSCT) are a major cause of morbidity and mortality. Early clinical trials demonstrate that adoptive transfer of donor-derived virus-specific T cells to restore virus-specific immunity is an effective strategy to control CMV and EBV infection after HSCT, conferring protection in 70%-90% of patients. The field has evolved rapidly to develop solutions to some of the manufacturing challenges identified in early clinical studies, such as prolonged in vitro culture, optimization of the purity of the virus-specific T cell product, the potential limitations of targeting a single viral antigen, and how to manage the patient with a virus-naive donor. This Review both discusses the seminal early studies and explores cutting-edge novel technologies that broaden the feasibility of and the scope for delivering virus-specific T cells to patients after HSCT.
异基因造血干细胞移植（HSCT）后巨细胞病毒（CMV）和爱泼斯坦-巴尔病毒（EBV）感染是发病和死亡的主要原因。早期临床试验表明，过继转移供体来源的病毒特异性T细胞以恢复病毒特异性免疫是控制HSCT后CMV和EBV感染的有效策略，可为70%-90%的患者提供保护。该领域发展迅速，以应对早期临床研究中发现的一些生产挑战，如体外长时间培养、病毒特异性T细胞产品纯度的优化、靶向单一病毒抗原的潜在局限性，以及如何处理供体未感染过病毒的患者。本综述既讨论了开创性的早期研究，也探讨了前沿新技术，这些技术拓宽了HSCT后为患者提供病毒特异性T细胞的可行性和范围。
