Antiviral Responses following L-Leucyl-L-Leucine Methyl Esther (LLME)-Treated Lymphocyte Infusions: Graft-versus-Infection without Graft-versus-Host Disease
| Autor: | William R. Drobyski, Dolores Grosso, Phyllis Flomenberg, John I. Wagner, Julie-An Talano, Robert Korngold, Andres Ferber, J. Brunner, Neal Flomenberg, Joanne Filicko-O'Hara, Bijoyesh Mookerjee, Carolyn A. Keever-Taylor, Thea M. Friedman, Irina Kakhniashvili |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Opportunistic infection T-Lymphocytes medicine.medical_treatment Lymphocyte Graft vs Host Disease Hematopoietic stem cell transplantation Article Donor lymphocyte infusion Immune reconstitution opportunistic infection Cohort Studies Young Adult 03 medical and health sciences 0302 clinical medicine Immune system T-Lymphocyte Subsets medicine Humans Aged 030304 developmental biology 0303 health sciences Transplantation business.industry Hematopoietic Stem Cell Transplantation Immunosuppression Dipeptides Hematology Middle Aged Flow Cytometry medicine.disease 3. Good health Graft-versus-host disease medicine.anatomical_structure Lymphocyte Transfusion Immunology Hematopoietic progenitor cell transplant business CD8 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 15:1609-1619 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2009.08.020 |
| Popis: | Although allogeneic hematopoietic progenitor cell transplant (HPCT) is curative therapy for many disorders, it is associated with significant morbidity and mortality, which can be related to graft-versus-host disease (GVHD) and the immunosuppressive measures required for its prevention and/or treatment. Whether the immunosuppression is pharmacologic or secondary to graft manipulation, the graft recipient is left at increased risk of the threatening opportunistic infection. Refractory viral diseases in the immunocompromised host have been treated by infusion of virus-specific lymphotyces and by unmanipulated donor lymphocyte infusion (DLI) therapy. L-leucyl-L-leucine methyl ester (LLME) is a compound that induces programmed cell death of natural killer (NK) cells, monocytes, granulocytes, most CD8(+) T cells, and a small fraction of CD4(+) T cells. We have undertaken a study of the use of LLME-treated DLI following T cell-depleted allogeneic HPCT, specifically to aid with immune reconstitution. In this ongoing clinical trial, we have demonstrated the rapid emergence of virus-specific responses following LLME DLI with minimal associated GVHD. This paper examines the pace of immune recovery and the rapid development of antiviral responses in 6 patients who developed viral infections during the time period immediately preceding or coincident with the administration of the LLME DLI. |
| Databáze: | OpenAIRE |
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