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Use of low cell dose for unmanipulated donor lymphocyte for management of cytomegalovirus infection: A single‐center experience
Author(s) -
Uygun Vedat,
Karasu Gülsün,
Daloğlu Hayriye,
Öztürkmen Seda,
Yalçın Koray,
Çelen Safiye Suna,
Yeşilipek Akif
Publication year - 2020
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.13882
Subject(s) - medicine , cytomegalovirus , donor lymphocyte infusion , single center , refractory (planetary science) , hematopoietic stem cell transplantation , cytomegalovirus infection , complication , salvage therapy , immunology , transplantation , chemotherapy , human cytomegalovirus , virus , viral disease , herpesviridae , physics , astrobiology
Abstract 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 × 10 4 /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.