EBV Cellular Immunotherapy Project
EBV Fact Sheet
|
The EBV Cellular Immunotherapy Project is designed to determine the
feasibility of treating patients who develop lymphomas following
transplantation. Most of these lymphomas are caused by a common virus
called Epstein-Barr virus (EBV), better known for its ability to cause
infectious mononucleosis or glandular fever. This virus is capable of
infecting a subset of lymphocytes referred to as B lymphocytes and
causing them to grow.
In healthy people the growth of these B cells is inconsequential since it is restrained by cytotoxic T lymphocytes (CTL). However in transplant patients whose immune system is dampened by drugs to prevent graft rejection, these rapidly growing cells can result in lymphomas in a life-threatening disorder known as post-transplant lymphoproliferative disease (PTLD).
EBV Project Strategy
In this project we have been treating transplant patients with these lymphomas by growing their CTL in the test tube and then re-infusing them into the patient. In some instances, this has resulted in cure of the disease. Furthermore, we have been monitoring a cohort of transplant patients to determine the relationship between the levels of CTL and EBV in the blood and the development of lymphomas. This study involves all of the major transplant units in Australia.In the past year, 20 patients have been identified for intensive monitoring while there are a further 20 patients with this lymphoma who could potentially receive our therapy. Overall, the rate of recruitment of patients in the past year has been above expectations although a relatively low number has been treated with their CTL.
Two patients have received our therapy during the past year although in neither case were the circumstances ideal. In the first case, the nature of the lymphoma was such that the level of EBV infection was sub-optimal and, although an initial improvement in clinical status was observed, the patient eventually died.
In the second case, the lymphoma had spread to the central nervous system. Again, although there were indications of an improvement in certain measurable parameters, the patient died. Overall, our experience in the past year reinforces our view that appropriate patient selection is important for the success of this treatment.
