title: Cytotoxic T lymphocyte therapy for Epstein-Barr virus+ Hodgkin's disease.
abstract: Epstein Barr virus (EBV)+ Hodgkin's disease (HD) expresses clearly identified tumor antigens derived from the virus and could, in principle, be a target for adoptive immunotherapy with viral antigen-specific T cells. However, like most tumor-associated antigens in immunocompetent hosts, these potential targets are only weakly immunogenic, consisting primarily of the latent membrane protein (LMP)1 and LMP2 antigens. Moreover, Hodgkin tumors possess a range of tumor evasion strategies. Therefore, the likely value of immunotherapy with EBV-specific cytotoxic effector cells has been questioned. We have now used a combination of gene marking, tetramer, and functional analyses to track the fate and assess the activity of EBV cytotoxic T lymphocyte (CTL) lines administered to 14 patients treated for relapsed EBV+ HD. Gene marking studies showed that infused effector cells could further expand by several logs in vivo, contribute to the memory pool (persisting up to 12 mo), and traffic to tumor sites. Tetramer and functional analyses showed that T cells reactive with the tumor-associated antigen LMP2 were present in the infused lines, expanded in peripheral blood after infusion, and also entered tumor. Viral load decreased, demonstrating the biologic activity of the infused CTLs. Clinically, EBV CTLs were well tolerated, could control type B symptoms (fever, night sweats, and weight loss), and had antitumor activity. After CTL infusion, five patients were in complete remission at up to 40 mo, two of whom had clearly measurable tumor at the time of treatment. One additional patient had a partial response, and five had stable disease. The performance and fate of these human tumor antigen-specific T cells in vivo suggests that they might be of value for the treatment of EBV+ Hodgkin lymphoma.
authors.affiliation: Center for Gene and Cell Therapy, Baylor College of Medicine, 6621 Fannin St., MC 3-3320, Houston, TX 77030, USA. cmbollar@txccc.org
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Bollard
authors.forename: Laura
authors.initials: L
authors.lastname: Aguilar
authors.forename: Karin C
authors.initials: KC
authors.lastname: Straathof
authors.forename: Benedikt
authors.initials: B
authors.lastname: Gahn
authors.forename: M Helen
authors.initials: MH
authors.lastname: Huls
authors.forename: Alexandra
authors.initials: A
authors.lastname: Rousseau
authors.forename: John
authors.initials: J
authors.lastname: Sixbey
authors.forename: M Victoria
authors.initials: MV
authors.lastname: Gresik
authors.forename: George
authors.initials: G
authors.lastname: Carrum
authors.forename: Melissa
authors.initials: M
authors.lastname: Hudson
authors.forename: Dagmar
authors.initials: D
authors.lastname: Dilloo
authors.forename: Adrian
authors.initials: A
authors.lastname: Gee
authors.forename: Malcolm K
authors.initials: MK
authors.lastname: Brenner
authors.forename: Cliona M
authors.initials: CM
authors.lastname: Rooney
authors.forename: Helen E
authors.initials: HE
authors.lastname: Heslop
mesh_terms: D000293:Adolescent; D000328:Adult; D002465:Cell Movement / Q000276:immunology; D002648:Child; D005260:Female; D006566:Herpesviridae Infections / Q000276:immunology / Q000473:pathology / Q000628:therapy* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000276:immunology*; D006689:Hodgkin Disease / Q000276:immunology / Q000473:pathology / Q000628:therapy* / Q000821:virology; D006801:Humans; D016219:Immunotherapy, Adoptive; D008297:Male; D011379:Prognosis; D012074:Remission Induction; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology / Q000637:transplantation*; D019139:Tumor Escape / Q000276:immunology; D019562:Viral Load; D014763:Viral Matrix Proteins / Q000276:immunology
chemical_list: C037662:EBV-associated membrane antigen, Epstein-Barr virus; D014763:Viral Matrix Proteins