For patients with relapsed T cell derived Epstein-Barr virus (EBV) and associated lymphomas or T cell chronic active EBV (CAEBV), outcomes are typically poor. Autologous T cells targeting EBV latent membrane proteins (LMPs) have been shown safe and effective for the treatment of patients with type II latency EBV-associated lymphomas for whom standard therapies have failed. However, up until now, the safety and efficacy of this treatment had not been established for patients who have received an allogeneic hematopoietic cell transplant (HCT).
The study included 26 patients (median age 24, range 2-60) who underwent allogeneic HCT for either B or T/NK cell EBV-associated lymphomas, or lymphoproliferative disease including CAEBV. Seven patients received LMP-specific T cells (LMP-Ts) for active disease; 19 patients received the treatment as adjuvant therapy for high-risk disease in two related phase 1 trials. No immediate infusion-related toxicities were reported.
The study cohort had a 2-year overall survival (OS) of 68% and improved
to 78% for patients in complete remission who received LMP-Ts infused in the
adjuvant setting. Patients with B cell disease (n=10) experienced better 2-year
OS than T cell mediated disease (n=16), 80% vs 60% respectively. The research findings
were compared to allogenic HCT data reported to the CIBMTR® (Center for
International Blood and Marrow Transplant Research®) for patients with NK/T
cell mediated disease who experienced 2 to-5-year
OS of 30% to-50%
respectively.
The researchers concluded that “donor-derived LMP-Ts are a safe and effective therapy to prevent relapse after transplant in patients with B- or T-cell-derived EBV-associated lymphomas or lymphoproliferative disorders and supports the infusion of LMP-specific T cells as adjuvant therapy to improve outcomes in the post-transplant setting.”