Adoptive cellular immunotherapy for Epstein-Barr virus-associated lymphoproliferative disease
Year: 2022
Type: article
Abstract: : This review focuses on the current state of adoptive cellular immunotherapy for Epstein-Barr virus-associated lymphoproliferative disease (EBV-LD). EBV-positive post-transplant lymphoproliferative disease (PTLD) is a major complication of hematopoietic stem cell and solid organ transplantation. First successes with adoptive immunotherapy were described using donor lymphocyte infusion for the treatment of EBV+ PTLD in hematopoietic stem cell transplantation (HSCT) recipients but carried an appreciable risk of graft-versus-host disease (GVHD). Subsequently, EBV-specific T-lymphocytes (EBVSTs) were developed and have been evaluated clinically for the treatment of EBV-LD over the last two decades predominantly in specialized centers. With impending commercialization, current state and knowledge is critically reviewed. The objectives of this review are: (I) to describe different manufacturing strategies of EBV specific T-lymphocytes (EBVSTs); (II) to review different EBVST donor options and their advantages and limitations; (III) to summarize current clinical experience with adoptive cellular therapy for EBV-LD and finally; (IV) to explore the potential for combination therapies with other immunotherapeutic strategies. This review is based on a review of published literature spanning 20 years from 2000 to 2020 in addition to personal experience and data from the authors. EBVSTs can be readily produced from seropositive donors using good-manufacturing-practice (GMP)-compliant protocols and cryopreserved for future use. In clinical trials, adoptive cellular therapy using EBVSTs has shown impressive results in immunocompromised patients with EBV-LD and there is the potential for wider use. Current research is focused on strategies to enhance EBVST potency in vivo through genetic engineering as well as combination therapies.
Source: Annals of Lymphoma
DOI: 10.21037/aol-21-43
Institutions: Children's National, George Washington University
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4285555586