CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
EBV 特异性 T 细胞治疗异基因干细胞移植后 EBV 相关移植后淋巴增殖性疾病的长期疗效：一项真实世界研究
英文原题：Long-Term Efficacy of Epstein-Barr Virus-Specific T Cells for Epstein-Barr Virus-Associated Post-Transplantation Lymphoproliferative Disorder after Allogeneic Stem Cell Transplantation: A Real-World Study.
查看英文原题
Long-Term Efficacy of Epstein-Barr Virus-Specific T Cells for Epstein-Barr Virus-Associated Post-Transplantation Lymphoproliferative Disorder after Allogeneic Stem Cell Transplantation: A Real-World Study.
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中文摘要
EBV相关移植后淋巴增殖性疾病（EBV-PTLD）仍然是异基因造血干细胞移植（allo-HSCT）后危及生命的并发症，尤其是在利妥昔单抗难治性病例中。过继转移EBV特异性细胞毒性T淋巴细胞（EBV-CTLs）为恢复抗病毒免疫提供了一种有前景的策略，但长期疗效数据仍然有限，尤其是在单倍体相合移植受者中。
我们开展了一项回顾性研究，纳入41例诊断为EBV-PTLD并接受供者来源EBV-CTLs的单倍体相合HSCT受者。在中位随访60个月期间，对患者进行病毒学应答、不良事件和移植结局监测。EBV-CTLs在中位EBV再激活后25天和中位PTLD诊断后19天给予，此前已接受中位4次（范围，2至8次）利妥昔单抗治疗。输注后第42天，总缓解率为87.8%（95%置信区间[CI]，72.0%至95.0%），同时EBV DNA峰值水平显著下降。1年总生存率为68.0%（95% CI，51.3%至80.0%），且生存率保持稳定，至5年时无显著下降。供者来源EBV-CTLs是单倍体相合HSCT后EBV-PTLD的一种安全有效的治疗方法。
我们的研究结果支持细胞免疫治疗在管理移植后病毒并发症方面的长期疗效。
展开英文摘要原文
Epstein-Barr virus-associated post-transplant lymphoproliferative disorder (EBV-PTLD) remains a life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), especially in rituximab-refractory cases. Adoptive transfer of EBV-specific cytotoxic T lymphocytes (EBV-CTLs) offers a promising strategy to restore antiviral immunity, but long-term efficacy data remain limited, particularly in haploidentical transplant recipients.
We conducted a retrospective study of 41 haploidentical HSCT recipients diagnosed with EBV-PTLD who received donor-derived EBV-CTLs. Patients were monitored for virologic response, adverse events, and transplant outcomes over a median follow-up of 60 months. EBV-CTLs were administered at a median of 25 days after EBV reactivation and 19 days after PTLD diagnosis, following a median of 4 (range, 2 to 8) doses of rituximab.
By day 42 postinfusion, the overall response rate was 87. 8% (95% confidence interval [CI], 72. 0% to 95. 0%), accompanied by a marked reduction in peak EBV DNA levels. The 1-year overall survival rate was 68. 0% (95% CI, 51. 3% to 80. 0%), and survival remained stable without significant decline up to 5 years. Donor-derived EBV-CTLs are a safe and effective treatment for EBV-PTLD following haploidentical HSCT.
Our findings support the long-term efficacy of cellular immunotherapy in managing viral complications post-transplantation.
论文信息
- 作者
- Sun HL、Fu Q、Zhao XY、Yan CH、Zhang YY、Mo XD、Chen YH、Xu LP
- 第一作者单位
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China.China
- 通讯作者单位
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Cell and Gene Therapy for Hematologic Malignancies, Peking University, Beijing, China. Electronic address: peixuying@pku.edu.cn.China
- 期刊
- Transplantation and cellular therapy2025 Dec
- 原文标识
- PubMed 40865682 · DOI 10.1016/j.jtct.2025.08.017