Adoptive immunotherapy with antigen-specific T cells during extracorporeal membrane oxygenation (ECMO) for adenovirus-related respiratory failure in a child given haploidentical stem cell transplantation

Pediatr Blood Cancer. 2014 Feb;61(2):376-9. doi: 10.1002/pbc.24753. Epub 2013 Aug 26.

Abstract

We report on the successful infusion of human adenovirus (HAdV)-specific T cells in a child with congenital amegakaryocytic thrombocytopenia, given T-cell-depleted hematopoietic stem cell transplantation (HSCT) from the HLA-haploidentical mother during extracorporeal membrane oxygenation (ECMO) for severe HAdV-related respiratory failure. Donor-derived, interferon (IFN)-γ-secreting HAdV-specific T cells were enriched using the cytokine capture assay, after in vitro stimulation with overlapping peptides from the immunodominant HAdV5 hexon protein. Two weeks after T-cell transfer, viral load decreased and ECMO was discontinued. T-cell responses to HAdV antigens were documented after four weeks and were associated with viral clearance, immune reconstitution and clinical amelioration.

Keywords: ECMO; T lymphocyte; adenovirus; immune recovery; immunotherapy; stem cell transplantation.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenovirus Infections, Human / etiology
  • Adenovirus Infections, Human / therapy*
  • Adenoviruses, Human / immunology
  • Capsid Proteins / immunology*
  • Child
  • Congenital Bone Marrow Failure Syndromes
  • Extracorporeal Membrane Oxygenation*
  • Humans
  • Immunotherapy, Adoptive*
  • Interferon-gamma / metabolism
  • Lymphocyte Depletion
  • Male
  • Peptide Fragments / immunology
  • Prognosis
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / therapy*
  • Stem Cell Transplantation / adverse effects*
  • T-Lymphocytes / immunology*
  • T-Lymphocytes / virology
  • Thrombocytopenia / complications*
  • Thrombocytopenia / immunology
  • Thrombocytopenia / therapy
  • Transplantation, Homologous
  • Viral Load

Substances

  • Capsid Proteins
  • Peptide Fragments
  • hexon capsid protein, Adenovirus
  • Interferon-gamma

Supplementary concepts

  • Congenital amegakaryocytic thrombocytopenia