Reconstitution of Cellular Immunity against Cytomegalovirus in Recipients of Allogeneic Bone Marrow by Transfer of T-Cell Clones from the Donor

• Published in: The New England journal of medicine Vol. 333; no. 16; pp. 1038 - 1044
• Main Authors: Walter, Elizabeth A, Greenberg, Philip D, Gilbert, Mark J, Finch, Rosalynde J, Watanabe, Käthe S, Thomas, E. Donnall, Riddell, Stanley R
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 19-10-1995
• Subjects: Adolescent; Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Bone marrow; Bone Marrow Transplantation - adverse effects; Bone Marrow Transplantation - immunology; Bone marrow, stem cells transplantation. Graft versus host reaction; Clone Cells; cytomegalovirus; Cytomegalovirus - immunology; Cytomegalovirus Infections - etiology; Cytomegalovirus Infections - immunology; Cytomegalovirus Infections - prevention & control; Female; Humans; Immunity, Cellular; Immunosuppression - adverse effects; Immunotherapy, Adoptive - adverse effects; Male; Medical research; Medical sciences; Middle Aged; Mortality; T-Lymphocytes, Cytotoxic - immunology; T-Lymphocytes, Cytotoxic - transplantation; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation, Homologous - immunology; Transplants & implants; Treatment Outcome; Human; Cell cloning; Cytomegalovirus; Intravenous administration; Herpesviridae; Transplantation; Cellular immunity; Betaherpesvirinae; Infection; Virus; Treatment; Perfusion; Viral disease; T-Lymphocyte; Bone marrow; Graft
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199510193331603

Reactivation of latent cytomegalovirus (CMV) infection in immunocompromised patients causes considerable morbidity and mortality.
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CMV is excreted in the urine after allogeneic bone marrow transplantation by approximately 70 percent of CMV-seropositive recipients and 30 percent of CMV-seronegative recipients whose donors are seropositive.
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Without ganciclovir prophylaxis, CMV disease develops in half the patients with CMV reactivation.
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CMV pneumonia, the most common form of CMV disease, has a mortality rate of 30 to 60 percent.
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Although ganciclovir prophylaxis reduces the incidence of CMV disease early after transplantation, it is complicated by the occurrence of severe neutropenia in . . .