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Cytotoxic T‐lymphocyte therapy for post‐transplant lymphoproliferative disorder after solid organ transplantation in children
Author(s) -
Chiou Fang Kuan,
Beath Sue V.,
Wilkie Gwen M.,
Vickers Mark A.,
Morland Bruce,
Gupte Girish L.
Publication year - 2018
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13133
Subject(s) - medicine , ctl* , post transplant lymphoproliferative disorder , transplantation , immunology , gastroenterology , epstein–barr virus , antigen , virus , cd8
Abstract EBV ‐ CTL immunotherapy targets EBV antigens expressed by tumor cells in PTLD . Data on outcome of EBV ‐ CTL in pSOT patients are limited. The aim of the study is to describe our experience with allogeneic, third‐party EBV ‐ CTL for the treatment of PTLD in pSOT patients in a single tertiary center. Retrospective review was performed of all pSOT patients who received EBV ‐ CTL for PTLD . PTLD was diagnosed using World Health Organization histologic criteria. EBV ‐ CTL s were derived from human leukocyte antigen‐typed, EBV ‐seropositive third‐party donors, and cryopreserved and maintained by an accredited national blood transfusion service. Ten patients received EBV ‐ CTL for histologically proven PTLD from 1999 to 2016 following liver (n=5), combined intestinal/liver (n=4), and liver/kidney (n=1) transplantation. PTLD occurred at median age of 40 months (range: 12‐144) and median post‐transplant interval of 8 months (range: 2‐107). Seven had monomorphic, two had polymorphic, and one had Hodgkin‐type PTLD . All were of B‐cell origin and EBV ‐positive on histology. EBV ‐ CTL achieved an overall remission rate of 80% (8 of 10). Transient adverse effects included fever, tachycardia, and vomiting. None developed graft‐versus‐host disease or opportunistic infections. EBV ‐ CTL is an effective treatment for PTLD in pSOT patients, with good remission rate and minimal toxicity.