Table 1.
Patients' characteristics.
| AdV | CMV | EBV | ADV+CMV | Total | |
|---|---|---|---|---|---|
| Patients | 13 | 7 | 8 | 1 | 29 |
| Adults | 7 | 3 | 2 | 0 | 12 (41%) |
| Children (<18 years) | 6 | 4 | 6 | 1 | 17 (59%) |
| Sex (F/M) | 13/0 | 3/4 | 5/2 | 0/1 | 21/8 |
| Age (years) [min–max] | 32 [1–67] | 2 [0.6–68] | 13 [1–40] | 5 | 14 [0.6–68] |
| Initial disease (n) | |||||
| Primary immunodeficiency | 4 | 3 | 3 | 0 | 11 |
| Blackfan‐Diamond anemia | 0 | 0 | 0 | 1 | 1 |
| Dyskeratosis congenita | 0 | 1 | 0 | 0 | 1 |
| Idiopathic aplastic anemia | 0 | 0 | 1 | 0 | 1 |
| Sickle cell disease | 1 | 0 | 0 | 0 | 1 |
| Acute myeloid leukemia | 3 | 1 | 1 | 0 | 5 |
| Acute lymphoid leukemia | 1 | 1 | 1 | 0 | 3 |
| Myelodysplastic syndrome | 1 | 1 | 1 | 0 | 3 |
| Chronic myeloid leukemia | 1 | 0 | 0 | 0 | 1 |
| Richter's syndrome | 1 | 0 | 0 | 0 | 1 |
| Adult T‐cell lymphoma | 1 | 0 | 0 | 0 | 1 |
| Graft source | |||||
| BM | 7 | 2 | 2 | 1 | 12 (41.4%) |
| PBSC | 5 | 4 | 5 | 0 | 14 (48.3%) |
| CBU | 1 | 1 | 1 | 0 | 3 (10.3%) |
| Graft donor | |||||
| MSD | 1 | 1 | 1 | 0 | 3 (10%) |
| Unrelated donors | 6 | 2 | 4 | 1 | 14 (48%) |
| MUD 10/10 | 5 | 2 | 4 | 1 | 12 |
| MMUD 9/10 | 1 | 0 | 0 | 0 | 1 |
| MMUD (≤8/10) | 0 | 0 | 1 | 0 | 1 |
| Haploidentical donors | 5 | 3 | 1 | 0 | 9 (31%) |
| CBU | 1 | 1 | 1 | 0 | 3 (10%) |
| Conditioning regimen | |||||
| Myeloablative | 2 | 2 | 2 | 0 | 6 (21%) |
| Reduced‐intensity conditioning | 9 | 1 | 4 | 0 | 14 (48%) |
| Nonmyeloablative | 2 | 3 | 2 | 1 | 8 (28%) |
| T‐cell depletion ex vivo (T‐depleted graft) | 0 | 1 | 1 | 0 | 2 |
| T‐cell depletion in vivoa | |||||
| Anti‐thymocyte globulin (ATG) | 8 | 4 | 5 | 0 | 17 (59%) |
| Cyclophosphamide | 5 | 2 | 0 | 0 | 7 |
| Alemtuzumab | 2 | 1 | 3 | 1 | 7 |
| Median time between allo‐SCT and infection (days) [min‐max] | 46 [3–1372] | 31 [0–130] | 64.5 [13–163] | 18 | 50 [21–300] |
| GVH disease prophylaxis | |||||
| Ciclosporin A+MMF | 7 | 5 | 5 | 0 | 17 (59%) |
| Ciclosporin alone | 6 | 1 | 2 | 1 | 10 |
| None | 0 | 1 | 1 | 0 | 2 |
| GVHD before VST | 8 | 2 | 1 | 0 | 11 (38%) |
| Acute GVHD grade I–II | 1 | 1 | 0 | 0 | 2 |
| Acute GVHD grade III–IV | 7 | 1 | 1 | 0 | 9 |
| Ruxolitinib before VST | 2 | 1 | 1 | 0 | 4 |
| Median lines of antiviral therapy before VST (range)b | 2 (1–3) | 3 (2–4) | 1 (0–5) | 2 | 2 (0–5) |
| Viral status (n. of replication/disease) | 10/3 | 2/5 | 4/4 | 1/0 | 17/12 |
| Mean viral load at D0 (log) (±SD) | 4.88 (±1.79) | 3.64 (±1.14) | 4.06 (±1.07) | ADV 5.05/CMV 3.99 | 4.34 (±1.47) |
| VST origin | |||||
| Graft donor | 8 | 3 | 2 | 0 | 13 (45%) |
| Third‐party donor | 5 | 4 | 6 | 1 | 16 (55%) |
| Median time between infection and VST infusion (range) | 39 (10‐89) | 85 (19‐216) | 52 (21‐310) | 53 | 51,5 (10‐310) |
| Mean infused CD3+T‐cells (104/kg) (±SD)c | 0.42 ± 0.35 | 3.29 ± 5.06 | 0.84 ± 0.43 | 0.5 ± 0.02 | 1.43 (±3.06) |
Abbreviations: AdV, adenovirus; BM, bone marrow; CBU, cord blood unit; CMV, cytomegalovirus; EBV, Epstein Barr virus; F/M, female/male; MMF, mycophenolate mofetil; MMUD, mismatched unrelated donor; MSD, matched sibling donor; MUD, matched unrelated donor; PBSC, peripheral blood stem cells, SD, standard deviation.
28 patients received a T‐depletion post‐allo‐SCT (patients 6 and 7 received an ex vivo T‐depleted graft). Among these 28 patients, patient 6 (AdV‐VST) received both alemtuzumab and cyclophosphamide (haploidentical donor), patient 3 (AdV‐VST) and patient 18 (CMV‐VST) received both ATG and cyclophosphamide because of a FLAMSA‐RIC conditioning regimen and a haploidentical donor, respectively. Before infusion, 11 patients were treated for aGVHD (grade I–II: n = 2, grade III–IV: n = 9) with corticosteroids and patients received ruxolitinib.
One patient (patient 25) received an allo‐SCT as a curative treatment for a chronic Aichi virus infection with renal failure secondary to Bruton's agammaglobulinemia. He was not treated with rituximab before EBV‐VST because the B‐cell depletion for EBV replication would have delayed the immune reconstitution necessary to control the Aichi virus.
Taking into account 34 infusions.