CHRU de Nancy, Unité de Thérapie cellulaire et Tissus and FR 3209, Vandoeuvre-Lès-Nancy, France.
Université de Lorraine, UMR 7365 and FR 3209 CNRS-INSERM-UL-CHU, Vandoeuvre-Lès-Nancy, France.
Bone Marrow Transplant. 2018 Feb;53(2):114-122. doi: 10.1038/bmt.2017.232. Epub 2017 Oct 23.
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for treatment of some malignant and non-malignant hematological diseases. However, post-HSCT patients are severely immunocompromised and susceptible to viral infections, which are a major cause of morbidity and mortality. Although antiviral agents are now available for most types of viral infections, they are not devoid of side effects and their efficacy is limited when there is no concomitant antiviral immune reconstitution. In recent decades, adoptive transfer of viral-specific T cells (VSTs) became an alternative treatment for viral infection after HSCT. However, two major issues are concerned in VST transfer: the risk of GVHD and antiviral efficacy. We report an exhaustive review of the published studies that focus on prophylactic and/or curative therapy by donor VST transfer for post-HSCT common viral infections. A low incidence of GVHD and a good antiviral efficacy was observed after adoptive transfer of VSTs from HSCT donor. Viral-specific T-cell transfer is a promising approach for a broad clinical application. Nevertheless, a randomized controlled study in a large cohort of patients comparing antiviral treatment alone to antiviral treatment combined with VSTs is still needed to demonstrate efficacy and safety.
异基因造血干细胞移植（HSCT）是治疗某些恶性和非恶性血液病的一种有治愈可能的选择。然而，HSCT 后患者的免疫严重受损，容易受到病毒感染，这是发病率和死亡率的主要原因。尽管现在有针对大多数类型病毒感染的抗病毒药物，但它们并非没有副作用，而且在没有伴随的抗病毒免疫重建时，其疗效有限。近几十年来，过继转移病毒特异性 T 细胞（VST）已成为 HSCT 后病毒感染的一种替代治疗方法。然而，在 VST 转移中存在两个主要问题：移植物抗宿主病（GVHD）的风险和抗病毒疗效。我们报告了对已发表的研究进行的全面综述，这些研究侧重于供体 VST 转移对 HSCT 后常见病毒感染的预防和/或治疗。从 HSCT 供体中过继转移 VST 后，观察到 GVHD 的发生率低且抗病毒疗效好。病毒特异性 T 细胞转移是一种有广泛临床应用前景的方法。然而，仍需要在大量患者中进行随机对照研究，比较单独抗病毒治疗与抗病毒治疗联合 VSTs 的疗效和安全性。
