title: Complete regression of posttransplant lymphoproliferative disease using partially HLA-matched Epstein Barr virus-specific cytotoxic T cells.
abstract: BACKGROUND
  Adoptive immunotherapy with autologous and donor-derived cytotoxic T lymphocytes (CTL) has recently been used to treat Epstein Barr virus (EBV)-positive posttransplant lymphoproliferative disease (PTLD).
  
  
  RESULTS
  We report complete regression of EBV-positive PTLD in an 18-month-old small bowel and liver transplant recipient after one infusion of partially human leukocyte antigen (HLA)-matched EBV-specific CTL grown ex vivo from an EBV seropositive unrelated blood donor. No infusion-related toxicity or evidence of graft-versus-host disease was observed. The tumor showed signs of regression within 1 week and EBV load in peripheral blood dropped to undetectable levels. Limiting dilution analyses (LDA) detected no EBV-specific CTL precursor (CTLp) cells before the infusion, and high numbers of CTLp at 4 hr and 24 hr post-CTL infusion. There was a reversal of the CD4/8 ratio in peripheral blood and an increase in HLA-DR positive CD8 cells. The patient has been in complete remission for 24 months.
  
  
  CONCLUSIONS
  If this success is repeated in more PTLD patients, then stored CTL could be used for antiviral and antitumor therapies in immunocompromised patients.
authors.affiliation: Laboratory for Clinical and Molecular Virology, The University of Edinburgh, Summerhall, Edinburgh EH9 1QH, United Kingdom. t.haque@ed.ac.uk
authors.forename: T
authors.initials: T
authors.lastname: Haque
authors.forename: C
authors.initials: C
authors.lastname: Taylor
authors.forename: G M
authors.initials: GM
authors.lastname: Wilkie
authors.forename: P
authors.initials: P
authors.lastname: Murad
authors.forename: P L
authors.initials: PL
authors.lastname: Amlot
authors.forename: S
authors.initials: S
authors.lastname: Beath
authors.forename: P J
authors.initials: PJ
authors.lastname: McKiernan
authors.forename: D H
authors.initials: DH
authors.lastname: Crawford
mesh_terms: D006684:HLA-DR Antigens / Q000235:genetics; D006412:Hematopoietic Stem Cells / Q000276:immunology; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016219:Immunotherapy, Adoptive; D007223:Infant; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000628:therapy*; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*
chemical_list: D006684:HLA-DR Antigens