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Article Abstract
Background: Epstein-Barr virus-associated post-transplant lymphoproliferative disorder (EBV-PTLD) remains a life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), especially in rituximab-refractory cases. Adoptive transfer of EBV-specific cytotoxic T lymphocytes (EBV-CTLs) offers a promising strategy to restore antiviral immunity, but long-term efficacy data, particularly in haploidentical transplant recipients, remain limited.
Methods: We conducted a retrospective study of 41 haploidentical HSCT recipients diagnosed with EBV-PTLD and received donor-derived EBV-CTLs. Patients were monitored for virological response, adverse events and transplant outcomes over a median follow-up of 60 months.
Results: EBV-CTLs were administered at a median of 25 days post EBV reactivation and 19 days after PTLD diagnosis, following a median 4 (2-8) doses of rituximab. By day 42 post-infusion, the overall response rate (ORR) was 87.8% (95% CI, 72.0-95.0%), accompanied by a marked reduction in peak EBV DNA levels. The 1-year overall survival (OS) rate was 68.0% (95% CI, 51.3%-80.0%), and survival remained stable without significant decline up to 5 years.
Conclusions: Donor-derived EBV-CTLs are a safe and effective treatment for EBV-PTLD following haploidentical HSCT. Our findings support the long-term efficacy of cellular immunotherapy in managing viral complications post-transplant.
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| http://dx.doi.org/10.1016/j.jtct.2025.08.017 | DOI Listing |
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