Clinical outcome in 13 patients who received EBV-CTLs as therapy for proven or probable EBV-LPD
| Patient no. . | Donor . | Diagnostic findings . | Response to CTLs . | Recurrence . | Complications . | Long-term outcome . |
|---|---|---|---|---|---|---|
| 238 | 6/6 URD | Fever, lymphadenopathy, and lung nodules; biopsy-proven EBV- LPD | CR | None | None | Died of relapsed secondary AML at 2 years |
| 345 | 6/6 URD | Fever, lymphadenopathy, abnormal liver function, and elevated EBV-DNA | CR | None | Transient increase in transaminases | Alive at 13 years |
| 324 | 6/6 URD | Fever, extensive bulky, and widespread adenopathy; biopsy-proven EBV-LPD | CR | None | Swelling and sloughing during response requiring ventilation | Alive at 13 years |
| 401 | 6/6 URD | Fever and enlarged adenoids; biopsy-proven EBV-LPD | CR | None | Swelling during response | Alive at 12 years |
| 426 | 5/6 URD | Fever, adenopathy, and extensive pulmonary nodules; biopsy-proven EBV-LPD | No response | Progressive disease | NA | Died of progressive EBV-LPD resistant to CTLs at 25 days |
| 2–1 | 6/6 URD | Increasing LDH and EBV-DNA levels suggested probable LPD for which CTL clones were administered (initial CTL line did not meet release criteria because of > 10% killing of PHA blasts); subsequent development of biopsy-proven LPD led to infusion of polyclonal line | CR | None | None | Died of respiratory failure secondary to another infection at 152 days; autopsy showed no evidence of EBV- LPD |
| 2–2 | 5/6 URD | Fever, adenopathy, spleen lesions, elevated EBV-DNA | CR | None | Exacerbation of preexisting GVHD | Died of Enterococcus faecalis sepsis at 250 days |
| 2–3 | 5/6 URD | Widespread biopsy-proven EBV-LPD with extensive CNS disease | No response | Progressive disease | None | Died of progressive EBV-LPD at 8 days |
| 2–4 | 6/6 URD | Biopsy proven EBV-LPD | CR | None | None | Alive at 10 years |
| CAGT-1 | 6/6 URD | Fevers and elevated EBV DNA | CR | None | None | Alive at 9 years |
| CAGT-2 | 6/6 URD | Fever, pulmonary infiltrates, and increased EBV-DNA level | CR | None | Small pleural effusion | Rituximab consolidation after steroid therapy; alive at 10 years |
| CAGT-677 | 6/6 URD | CNS lesions; biopsy-proven monoclonal EBV+ lymphoma | CR | None | None | Received hydroxyurea until CTLs available; alive at 7 years |
| CAGT-823 | 6/6 URD | Fever, pharyngitis, adenopathy, increased LDH, and elevated EBV-DNA level | CR | None | None | Alive at 5 years |
| Patient no. . | Donor . | Diagnostic findings . | Response to CTLs . | Recurrence . | Complications . | Long-term outcome . |
|---|---|---|---|---|---|---|
| 238 | 6/6 URD | Fever, lymphadenopathy, and lung nodules; biopsy-proven EBV- LPD | CR | None | None | Died of relapsed secondary AML at 2 years |
| 345 | 6/6 URD | Fever, lymphadenopathy, abnormal liver function, and elevated EBV-DNA | CR | None | Transient increase in transaminases | Alive at 13 years |
| 324 | 6/6 URD | Fever, extensive bulky, and widespread adenopathy; biopsy-proven EBV-LPD | CR | None | Swelling and sloughing during response requiring ventilation | Alive at 13 years |
| 401 | 6/6 URD | Fever and enlarged adenoids; biopsy-proven EBV-LPD | CR | None | Swelling during response | Alive at 12 years |
| 426 | 5/6 URD | Fever, adenopathy, and extensive pulmonary nodules; biopsy-proven EBV-LPD | No response | Progressive disease | NA | Died of progressive EBV-LPD resistant to CTLs at 25 days |
| 2–1 | 6/6 URD | Increasing LDH and EBV-DNA levels suggested probable LPD for which CTL clones were administered (initial CTL line did not meet release criteria because of > 10% killing of PHA blasts); subsequent development of biopsy-proven LPD led to infusion of polyclonal line | CR | None | None | Died of respiratory failure secondary to another infection at 152 days; autopsy showed no evidence of EBV- LPD |
| 2–2 | 5/6 URD | Fever, adenopathy, spleen lesions, elevated EBV-DNA | CR | None | Exacerbation of preexisting GVHD | Died of Enterococcus faecalis sepsis at 250 days |
| 2–3 | 5/6 URD | Widespread biopsy-proven EBV-LPD with extensive CNS disease | No response | Progressive disease | None | Died of progressive EBV-LPD at 8 days |
| 2–4 | 6/6 URD | Biopsy proven EBV-LPD | CR | None | None | Alive at 10 years |
| CAGT-1 | 6/6 URD | Fevers and elevated EBV DNA | CR | None | None | Alive at 9 years |
| CAGT-2 | 6/6 URD | Fever, pulmonary infiltrates, and increased EBV-DNA level | CR | None | Small pleural effusion | Rituximab consolidation after steroid therapy; alive at 10 years |
| CAGT-677 | 6/6 URD | CNS lesions; biopsy-proven monoclonal EBV+ lymphoma | CR | None | None | Received hydroxyurea until CTLs available; alive at 7 years |
| CAGT-823 | 6/6 URD | Fever, pharyngitis, adenopathy, increased LDH, and elevated EBV-DNA level | CR | None | None | Alive at 5 years |
EBV-CTL indicates Epstein-Barr virus–cytotoxic T lymphocyte; EBV-LPD, Epstein-Barr virus–lymphoproliferative disease; URD, unrelated donor; CR, complete remission; AML, acute myeloid leukemia; NA, not applicable; LDH, lactate dehydrogenase; and CAGT, Center for Cell and Gene Therapy.