Hoenig, Manfred and Roesler, Joachim and Seidel, Markus G. and Albert, Michael H. and Hauck, Fabian and Maecker-Kolhoff, Britta and Eiz-Vesper, Britta and Kleinschmidt, Katharina and Debatin, Klaus-Michael and Jacobsen, Eva-Maria and Furlan, Ingrid and Suttorp, Meinolf and Schuetz, Catharina and Schulz, Ansgar S. (2021) Matched Family Donor Lymphocyte Infusions as First Cellular Therapy for Patients with Severe Primary T Cell Deficiencies. TRANSPLANTATION AND CELLULAR THERAPY, 27 (1). ISSN 2666-6375, 2666-6367
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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.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | IMMUNE CONSTITUTION; TRANSPLANTATION; RECONSTITUTION; T cell deficiency; Opportunistic infection; Donor lymphocyte transfusion; Matched family donor; T cell reconstitution; HSCT |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Pädiatrische Hämatologie, Onkologie und Stammzelltransplantation |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 21 Sep 2022 13:40 |
| Last Modified: | 21 Sep 2022 13:40 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47862 |
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