title: Epitope specificity and clonality of EBV-specific CTLs used to treat posttransplant lymphoproliferative disease.
abstract: In a recent phase II clinical trial using banked allogeneic CTL lines to treat EBV-associated posttransplant lymphoproliferative disease, a response rate of 52% was recorded 6 mo posttreatment. Tumor response was associated with an increase in both CTL/recipient HLA matches and CD4(+) T cells within the infused CTL lines. The present study was undertaken to correlate tumor response with CTL specificity. The majority of CTL lines infused recognized EBV-encoded nuclear Ag-3 proteins, but CTL protein specificity itself did not correlate with tumor response. Specificity in conjunction with donor/recipient functional HLA matching as opposed to HLA matching alone, however, was important for tumor response. CTL receptor TCR beta-chain variable gene subfamilies were polyclonal, with no preferential use of a particular family. However, tumor response was improved in those receiving CTL lines with polyclonal vs clonal distribution for subfamilies 2, 3, and 9. Interestingly, in five of six tumors (five Hodgkin's-like and one Burkitt's-like posttransplant lymphoproliferative disease) with restricted viral gene expression a complete response was recorded, although in some cases the tumor cells did not express the proteins recognized by the infused CTL. Thus CTL were advantageous when functionally HLA matched but for certain tumor types complete responses occurred in the absence of detectable specific CTL/tumor recognition. We suggest that either the allogenic CTL contained small, undetectable, EBV-specific, HLA-matched T cell populations or perhaps they stimulated nonspecific inflammatory responses in vivo, which were beneficial for tumor regression. These observations should be considered when designing and implementing CTL therapies.
authors.affiliation: Clinical and Basic Virology Laboratory, School of Biomedical Sciences, University of Edinburgh, Summerhall, Edinburgh, UK. kmcaulay@ed.ac.uk
authors.forename: Karen A
authors.initials: KA
authors.lastname: McAulay
authors.forename: Tanzina
authors.initials: T
authors.lastname: Haque
authors.forename: Gillian
authors.initials: G
authors.lastname: Urquhart
authors.forename: Christopher
authors.initials: C
authors.lastname: Bellamy
authors.forename: Deisy
authors.initials: D
authors.lastname: Guiretti
authors.forename: Dorothy H
authors.initials: DH
authors.lastname: Crawford
mesh_terms: D000595:Amino Acid Sequence; D002461:Cell Line, Transformed; D002478:Cells, Cultured; D017322:Clinical Trials, Phase II as Topic; D002999:Clone Cells; D015331:Cohort Studies; D018984:Epitopes, T-Lymphocyte / Q000235:genetics / Q000276:immunology*; D019309:Epstein-Barr Virus Nuclear Antigens / Q000235:genetics / Q000276:immunology*; D005260:Female; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000276:immunology* / Q000628:therapy* / Q000821:virology; D008297:Male; D008969:Molecular Sequence Data; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications / Q000276:immunology* / Q000628:therapy* / Q000821:virology; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology / Q000378:metabolism / Q000637:transplantation*
chemical_list: D018984:Epitopes, T-Lymphocyte; D019309:Epstein-Barr Virus Nuclear Antigens; D006680:HLA Antigens