Use of low cell dose for unmanipulated donor lymphocyte for management of cytomegalovirus infection: a single-center experience
Tezcan Karasu, Gulsun
Celen, Safiye Suna
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CitationUygun, V., Karasu, G., Daloğlu, H., Öztürkmen, S., Yalçın, K., Çelen, S. S., & Yeşilipek, A. (2020). Use of low cell dose for unmanipulated donor lymphocyte for management of cytomegalovirus infection: A single-center experience. Pediatric transplantation, e13882. Advance online publication. https://doi.org/10.1111/petr.13882
Although advancements have been made in monitoring and preventing viral infections in HSCT patients, CMV reactivation still remains a critical post-transplant complication. Adoptive cell therapy is an alternative to pharmacotherapy of CMV infection in refractory patients. We retrospectively reviewed CMV infection cases after allogeneic HSCT who received U-DLI as treatment. In total, five pediatric patients between the ages of 0.5-16 years that received U-DLI for a post-HSCT CMV infection were evaluated. The dose of CD3+ lymphocytes administered in DLI was 5 × 104 /kg, except in one patient transplanted from his sibling. One patient, who was transplanted from an unrelated donor, received U-DLI from his haploidentical mother. CMV titers dramatically reduced after U-DLI. If the availability of CMV-specific CTL is an issue, we propose that one should consider using the U-DLI therapy with low cell dose from a seropositive donor. In case the stem cell donor is seronegative and a seropositive donor is unavailable, using the U-DLI therapy from seropositive, haploidentical donors is a promising way of treatment. More studies need to be conducted to further confirm the safety and efficacy of this treatment procedure.