Adoptive therapy with cytomegalovirus‐specific T cells for cytomegalovirus infection after haploidentical stem cell transplantation and factors affecting efficacy

Abstract

Adoptive therapy with cytomegalovirus (CMV)-specific cytotoxic T lymphocytes (CMV-CTLs) has emerged as an effective method for CMV infection. However, the efficacy reportedly ranges from 50-90%, and factors affecting anti-CMV efficacy have not been established. We investigated the safety and efficacy of adoptive therapy with CMV-CTLs for CMV infection in 190 patients after haploidentical stem cell transplantation (haplo-SCT), and importantly, we analyzed the main factors affecting antiviral efficacy. The CMV peak titer decreased from 19 (range, 1.0-503.0) × 103 copies/ml to 3.9 (range, 0-112) × 103 copies/ml after CMV-CTL infusion. The cumulative complete response (CR) rates in the 1st , 4th , and 6th weeks after the first CMV-CTL infusion were 37.9% (95% CI 35.0%-40.8%), 76.8% (95% CI 70.7%-82.9%), and 89.5% (95% CI 85.2%-93.8%), respectively. In multivariate analysis, persistent CMV infection prior to CMV-CTL infusion (HR 2.29, 95% CI 1.29-4.06, P=0.005) and basiliximab treatment within 2 weeks of CMV-CTL infusion (HR 1.87, 95% CI 1.06-3.81, P=0.031) were independent predictors of poor antiviral efficacy of CMV-CTL therapy. Our data showed that adoptive therapy with CMV-CTLs is a safe and effective treatment for CMV infection after haplo-SCT. Persistent CMV infection and basiliximab treatment are correlated with poor anti-CMV efficacy of CMV-CTL therapy. This article is protected by copyright. All rights reserved.