Adoptive therapy with cytotoxic T lymphocytes (CMV-CTLs) specific to cytomegalovirus (CMV) has emerged as an effective treatment for CMV infection. However, the claimed efficacy ranges from 50% to 90%, and factors influencing anti-CMV efficacy have not been identified. Researchers studied the safety and efficacy of adoptive therapy with CMV-CTLs for CMV infection in 190 patients who had undergone haploidentical stem cell transplantation (haplo-SCT) and the most relevant factors influencing antiviral efficacy. After CMV-CTL infusion, the CMV peak titer reduced from 19 (range, 1.0–503.0)× 103 copies/mL to 3.9 (range, 0–112)× 103 copies/mL. The complete cumulative response (CR) rates in the first, fourth, and sixth weeks following the initial CMV-CTL injection were 37.9% (95% CI: 35.0–40.8), 76.8% (95% CI: 70.7–82.9), and 89.5% (95% CI: 85.2–93.3), respectively. Persistent CMV infection before CMV-CTL infusion (hazard ratio [HR] 2.29, 95% CI 1.29–4.06, P=.005) and basiliximab treatment within two weeks of CMV-CTL infusion (HR 1.87, 95% CI 1.06–3.81, P=.031) were independent predictors of poor antiviral efficacy of CMV-CTL therapy in multivariate analysis. The data demonstrated that adoptive therapy with CMV-CTLs was safe and effective for CMV infection following haplo-SCT. Poor anti-CMV efficacy of CMV-CTL therapy was connected with persistent CMV infection and basiliximab medication.
Source:onlinelibrary.wiley.com/doi/10.1002/ajh.26535
