Barrett A John, Prockop Susan, Bollard Catherine M
Stem Cell Allotransplantation Section, Hematology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Pediatric BMT Service, Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, USA.
Biol Blood Marrow Transplant. 2018 Mar;24(3S):S1-S6. doi: 10.1016/j.bbmt.2017.12.787.
Virus infection remains an appreciable cause of morbidity and mortality after hematopoietic stem cell transplantation (HSCT). Although pharmacotherapy and/or antibody therapy may help prevent or treat viral disease, these drugs are expensive, toxic, and often ineffective due to primary or secondary resistance. Further, effective treatments are limited for many infections (eg, adenovirus, BK virus), which are increasingly detected after alternative donor transplants. These deficiencies in conventional therapeutics have increased interest in an immunotherapeutic approach to viral disorders, leading to adoptive transfer of virus-specific cytotoxic T lymphocytes (VSTs), which can rapidly reconstitute antiviral immunity post-transplantation without causing graft-versus-host disease. This review will explore how the VST field has improved outcomes for many patients with life-threatening viral infections after HSCT, and how to broaden applicability beyond the "patient-specific" products, as well as extending to other viral diseases even outside the context of HSCT.
病毒感染仍然是造血干细胞移植（HSCT）后发病率和死亡率的一个重要原因。尽管药物治疗和/或抗体治疗可能有助于预防或治疗病毒疾病，但这些药物价格昂贵、有毒，而且由于原发性或继发性耐药往往无效。此外，对于许多感染（如腺病毒、BK病毒），有效治疗方法有限，这些感染在替代供体移植后越来越多地被检测到。传统治疗方法的这些不足增加了人们对病毒疾病免疫治疗方法的兴趣，导致采用病毒特异性细胞毒性T淋巴细胞（VST）的过继转移，这种细胞可以在移植后迅速重建抗病毒免疫力，而不会引起移植物抗宿主病。本综述将探讨VST领域如何改善了许多HSCT后患有危及生命的病毒感染患者的治疗结果，以及如何扩大“患者特异性”产品之外的适用性，甚至扩展到HSCT背景之外的其他病毒疾病。
