Low-dose infusions of CD45RA depleted donor lymphocytes after TCRα/β-depleted transplantation in patients with non-malignant disorders

S. L. Blagov; Благов С. Л.; L. N. Shelikhova; Шелихова Л. Н.; D. N. Balashov; Балашов Д. Н.; E. Y. Osipova; Осипова Е. Ю.; M. V. Efimenko; Ефименко М. В.; N. A. Khripkova; Хрипкова Н. А.; J. O. Muzalevskiy; Музалевский Я. О.; M. A. Dunaikina; Дунайкина М. А.; B. S. Pershin; Першин Б. С.; A. A. Maschan; Масчан А. А.; M. A. Maschan; Масчан М. А.

doi:10.24287/1726-1708-2019-18-3-9-21

Low-dose infusions of CD45RA depleted donor lymphocytes after TCRα/β-depleted transplantation in patients with non-malignant disorders

Authors: Blagov S.L.¹, Shelikhova L.N.¹, Balashov D.N.¹, Osipova E.Y.¹, Efimenko M.V.¹, Khripkova N.A.¹, Muzalevskiy J.O.¹, Dunaikina M.A.¹, Pershin B.S.¹, Maschan A.A.¹, Maschan M.A.¹
Affiliations:
1. Dmitriy Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology Ministry of Healthcare of Russian Federation
Issue: Vol 18, No 3 (2019)
Pages: 9-21
Section: PROMISING STUDIES
Submitted: 12.09.2019
Accepted: 12.09.2019
Published: 12.09.2019
URL: https://hemoncim.com/jour/article/view/255
DOI: https://doi.org/10.24287/1726-1708-2019-18-3-9-21
ID: 255

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Abstract

Viral infections are frequent causes of failure among the recipients of the HSCT with graft TCRα/β and CD19depletion. Adoptive transfer of memory T-cells by CD45RA-depleted donor lymphocytes infusions (memory DLI) may be useful in control of viral infections. The study was approved by the Independent Ethics Committee of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology. The work reflects the retrospective data analysis of 51 patients with non-malignant disorders who had received low dose memory DLI after HSCT. Up to 3 doses of donor lymphocytes were administered. Median follow-up for alive patients was 30 (18–49) months. We did not observe any allergic reactions, septic complications after memory DLI. The cumulative incidence of a de novo acute GVHD after DLI was 10% (95% CI: 4–22). Among 41% patients (n = 21) was detected CMV in the blood. In 73% of them (n = 16) CMV was detected before first DLI. Among patients who received DLI, 53% (n = 27) had documented appearance of virus-specific lymphocytes in peripheral blood (ELISPOT assay).Thus, the infusion of memory T-cells at a dose of 25–100 αβ 103/kg body weight of the recipient for CD3+ in the case of HSCT from a haploidentical donor and 100–300 αβ 103/kg for an unrelated HSCT. Infusions of low dose memory T-lymphocytes after transplant engraftment are safe, potentially effective and constitute a simple measure to prevent infections in the setting of alpha/beta T-cell-depleted transplantation.