ABSTRACT

Introduction

Cytomegalovirus (CMV) infection is widely prevalent but mostly harmless in immunocompetent individuals. In the post hematopoietic stem cell transplant (HSCT) setting unrestricted viral replication can cause end-organ damage (CMV disease) and, in a small proportion, mortality. Current management strategies are based on sensitive surveillance programmes, with the more recent introduction of an effective prophylactic antiviral drug, letermovir, but all aim to bridge patients until reconstitution of endogenous immunity is sufficient to constrain viral replication.

Areas covered

Over the past 25 years, the adoptive transfer of CMV-specific T-cells has developed from the first proof of concept transfer of CD 8 + T-cell clones, to the development of ‘off the shelf’ third party derived Viral-Specific T-cells (VSTs). In this review, we cover the current management of CMV, and discuss the developments in CMV adoptive cellular therapy.

Expert opinion

Due to the adoption of letermovir as a prophylaxis in standard therapy, the incidence of CMV reactivation is likely to decrease, and any widely adopted cellular therapy needs to be economically competitive. Current clinical trials will help to identify the patients most likely to gain the maximum benefit from any form of cell therapy.

中文翻译：

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巨细胞病毒感染的细胞疗法

摘要

介绍

巨细胞病毒 (CMV) 感染广泛流行，但在免疫功能正常的个体中大多无害。在造血干细胞移植 (HSCT) 后环境中，不受限制的病毒复制会导致终末器官损伤（CMV 疾病），并在一小部分导致死亡。当前的管理策略基于敏感的监测计划，最近引入了一种有效的预防性抗病毒药物莱特莫韦，但所有策略都旨在为患者提供桥梁，直到重建内源性免疫足以抑制病毒复制。

覆盖区域

在过去的 25 年中，CMV 特异性 T 细胞的过继转移已经从 CD 8 + T 细胞克隆概念转移的第一个证明发展到“现成”的第三方衍生病毒特异性 T 细胞的开发-细胞（VST）。在这篇综述中，我们介绍了 CMV 的当前管理，并讨论了 CMV 过继细胞疗法的发展。

专家意见

由于在标准疗法中采用莱特莫韦作为预防措施，CMV 再激活的发生率可能会降低，任何广泛采用的细胞疗法都需要具有经济竞争力。当前的临床试验将有助于确定最有可能从任何形式的细胞疗法中获得最大益处的患者。