Item type: | Article | ||||
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Journal or Publication Title: | Transplantation and Cellular Therapy | ||||
Publisher: | Elsevier | ||||
Place of Publication: | NEW YORK | ||||
Volume: | 27 | ||||
Number of Issue or Book Chapter: | 1 | ||||
Page Range: | 93.e1-93.e8 | ||||
Date: | 2021 | ||||
Institutions: | Medicine > Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation | ||||
Identification Number: |
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Keywords: | IMMUNE CONSTITUTION; TRANSPLANTATION; RECONSTITUTION; T cell deficiency; Opportunistic infection; Donor lymphocyte transfusion; Matched family donor; T cell reconstitution; HSCT | ||||
Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
Status: | Published | ||||
Refereed: | Yes, this version has been refereed | ||||
Created at the University of Regensburg: | Yes | ||||
Item ID: | 56590 |
Abstract
Patients with primary immunodeficiencies caused by severe defects in T cell immunity are at risk of acquiring lifethreatening infections. Cellular therapies are necessary to establish normal T cell function and to allow for long-term survival. This is most commonly achieved by hematopoietic stem cell transplantation (HSCT), but the outcome of this procedure is impaired if active infections are ...
Abstract
Patients with primary immunodeficiencies caused by severe defects in T cell immunity are at risk of acquiring lifethreatening infections. Cellular therapies are necessary to establish normal T cell function and to allow for long-term survival. This is most commonly achieved by hematopoietic stem cell transplantation (HSCT), but the outcome of this procedure is impaired if active infections are present at the time of HSCT. Donor lymphocyte infusions (DLIs) are a well-established therapeutic strategy following HSCT to treat viral infections, improve donor cell engraftment, or achieve graft-versus-leukemia activity in malignant disease. Here we present a cohort of 6 patients with primary T cell deficiencies who received transfusions of unselected mature donor lymphocytes prior and not directly related to allogeneic HSCT. DLIs obtained from the peripheral blood of HLA-identical (10/10) family donors were transfused without prior conditioning to treat or prevent life-threatening infections. All patients are alive with a follow-up of 0.5 to 16.5 years after the initial T cell administration. Additional cellular therapies were administered in 5 of 6 patients at 0.8 to 15 months after the first DLI. Mild cutaneous graft-versus-host disease (GVHD, stage <= 2) was observed in 3 of 6 patients and resolved spontaneously. We provide evidence that unselected HLA-identical DLIs can effectively prevent or contribute to overcome infections with a limited risk for GVHD in T cell deficient patients. The T cell system established by this readily available source can provide T cell function for years and can serve as a bridge to additional cellular therapies or, in specific conditions, as definite treatment. (C) 2020 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
Metadata last modified: 29 Feb 2024 12:28