Table 2.
Published trials using transplant donor-derived expanded single VSTs
| Virus | Patient number | VST activator | Acute GVHD | Antiviral effects | Reference |
|---|---|---|---|---|---|
| EBV | 113 | LCL | Eight had a recurrence of previous acute GVHD post-CTLs | Prophylaxis: none of 101 developed PTLD; treatment: induced CR in 11/13 patients | 9, 21, 31, 41 |
| EBV | 14 | LCL | None | CRs in 10 patients; 4 with progressive disease | 10 |
| EBV | 6 | LCL | None reported | Decreased EBV DNA levels in 5 patients; 1 patient died of PTLD | 42 |
| EBV | 1 | LCL | One patient reactivated acute skin GVHD | Patient attained CR | 43 |
| EBV | 1 | LCL | None | Patient failed to respond | 44 |
| EBV | 4 | LCL | None | CRs in 3 patients with recurrent PTLD post-rituximab; decrease in EBV DNA in patient without overt PTLD | 39 |
| CMV | 14 | CMV virion proteins; CD8 clones administered | Three patients developed grade 1 or 2 GVHD post- infusion; responded to steroids in all cases | Reconstitution of CMV-specific immunity in all patients | 12 |
| CMV | 8 | CMV lysate | None | Five cleared after 1st dose of CTL; 1 cleared after a 2nd dose; 1 did not clear; 1 not evaluable | 40 |
| CMV | 16 | DCs pulsed with CMV antigens derived from a CMV-infected human lung fibroblast cell line | Three developed grade 1 skin GVHD, which responded to topical steroids in all cases | Massive in vivo expansions of CMV-specific CTLs resulting in reconstitution of viral immunity. In 8 cases, antiviral drugs were not required, and subsequent episodes of reactivation occurred in only 2 patients | 11 |
| CMV | 25 | CMV antigen; clones administered | One case | Seven patients underwent CMV reactivation and 5 patients developed CMV disease, which was fatal in 2 patients | 45 |
| CMV | 9 | DCs pulsed with the immunodominant CD8+ HLA-A2 restricted epitope NLVPMVATV derived from pp65 | Three developed grade 3 GVHD, which was fatal in 1 patient | Increase in NLV-tetramer binding T cells in 6 recipients; 2 patients developed reactivation, which cleared without pharmacotherapy; no patients developed CMV disease | 26 |
| CMV | 7 | Peptide mixes derived from full-length pp65 and IE1 | None | Five of 7 patients had increase in CMV activity in peripheral blood | 46 |
| CMV | 16 | 15-mer peptides spanning the sequence of CMV-pp65 | None | Fourteen of 16 patients cleared CMV viremia | 27 |
| JCV | 1 | Stimulation with peptides derived from VP1 and large T-viral proteins | None | JCV-DNA was cleared in the cerebrospinal fluid | 47 |
JCV, polyomavirus JC.