Table 3

Follow-up after adoptive transfer of pp65-specific T cells

Patient no.Antiviral drugs before T-cell transferSite and symptoms of CMV infection before T-cell transferDay after SCT*In vivo expansion of transferred CMV-specific T cellsCourse of CMV infection 4 wk after T-cell transferClinical outcome/cause of death until last observationLast observation day after T-cell transfer†
1 Ganciclovir, foscarnet Pneumonia, viremia 158 In vivo expansion 14 d after T-cell transfer 2 log decrease of viral copies in peripheral blood Heart failure d 188 after SCT Succumbed d 30 
2 ganciclovir, foscarnet, cidofovir Meningoencephalitis, cerebro spinal fluid, viremia 308 Viability of tested samples too low after transport Negative PCR in CSF and blood Renal failure, d 425 after SCT Succumbed d 117 
3 Foscarnet, ganciclovir, cidofovir Fatigue, viremia 111 In vivo expansion 28 d after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Follow-up until d 357 
4 Ganciclovir Viremia 93 Specific T cells undetectable after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Last observation d 177 
5 Ganciclovir, foscarnet Viremia 50 In vivo expansion 28 d after T-cell transfer 600 CMV copies/mL blood Clearance of CMV from urine and throat until d 64, viremia until d 106 after SCT Follow-up until d 650 
6 Ganciclovir, foscarnet Pneumonia, viremia 146 Specific T cells undetectable after T-cell transfer 2 log decrease of CMV viremia delayed pulmonary toxicity syndrome d 172 after SCT Succumbed d 26 
7 valganciclovir Viremia 102 In vivo expansion 28 d after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Follow-up until d 56 
8 Ganciclovir Viremia 60 In vivo expansion 14 d after T-cell transfer Viremia Sepsis, heart failure d 79 after SCT Succumbed d 19 
9 Valganciclovir Dyspnea, diarrhea, fatigue, viremia 212 In vivo expansion 14 d after T-cell transfer Negative CMV PCR in blood, throat, and stool CMV reactivation after high-dose methylprednisolone at d 251 after SCT Last observation d 409 
10 Ganciclovir, cidofovir Pneumonia, viremia 19 In vivo expansion 8 d after T-cell transfer pp65 negative in peripheral blood; < 600 CMV DNA copies/mL blood Renal failure and respiratory failure d 45 after SCT Succumbed d 26 
11 Foscarnet, ganciclovir, cidofovir Encephalitis, cerebrospinal fluid, viremia 137 Transient in vivo expansion 10 d after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Follow-up until d 145 
12 Ganciclovir, foscarnet, cidofovir Reactivation since d 76 after SCT 116 Specific T cells undetectable after T-cell transfer Transient reduction of pp65 viremia cGVHD, upper GIT hemorrhage Follow-up until d 21 
13 Ganciclovir, foscarnet 3× CMV reactivation under treatment 64 In vivo expansion d 7 after T-cell transfer up to 3.6% at d 60 Clearance of pp65 viremia d 26 after T-cell transfer Clearance of CMV infection, no further ganciclovir treatment Follow-up until d 130 
14 Ganciclovir, foscarnet, cidofovir Blood 156 In vivo expansion 10 d after T-cell transfer 2 log decrease of CMV viremia Clearance of CMV infection Last observation d 112 
15 Ganciclovir, foscarnet Blood, urine 70 Viability of tested samples too low after transport Clearance of viremia d 14 after T-cell transfer No further CMV reactivation for 3 mo after T-cell transfer Last observation d 201 
16 Ganciclovir, foscarnet, cidofovir Blood, fatigue, diarrhea 199 In vivo expansion d 11 after T-cell transfer Clearance of CMV infection No further CMV reactivation for 2 mo after T-cell transfer Follow-up until d 390 
17 Ganciclovir, foscarnet, cidofovir Pneumonia, colitis, viremia 60 Transient in vivo expansion d 16 after T-cell transfer Transient reduction of viral load 1 log d 16 after T-cell transfer Died in multiorgan failure, mainly pneumonia 4 wk later Succumbed d 28 
18 Valganciclovir, foscavir, cidofovir Blood 70 In vivo expansion d 28 after T-cell transfer 2 log decrease of CMV viremia Clearance of CMV below threshold 6 wk after T-cell transfer Follow-up until d 220 
Patient no.Antiviral drugs before T-cell transferSite and symptoms of CMV infection before T-cell transferDay after SCT*In vivo expansion of transferred CMV-specific T cellsCourse of CMV infection 4 wk after T-cell transferClinical outcome/cause of death until last observationLast observation day after T-cell transfer†
1 Ganciclovir, foscarnet Pneumonia, viremia 158 In vivo expansion 14 d after T-cell transfer 2 log decrease of viral copies in peripheral blood Heart failure d 188 after SCT Succumbed d 30 
2 ganciclovir, foscarnet, cidofovir Meningoencephalitis, cerebro spinal fluid, viremia 308 Viability of tested samples too low after transport Negative PCR in CSF and blood Renal failure, d 425 after SCT Succumbed d 117 
3 Foscarnet, ganciclovir, cidofovir Fatigue, viremia 111 In vivo expansion 28 d after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Follow-up until d 357 
4 Ganciclovir Viremia 93 Specific T cells undetectable after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Last observation d 177 
5 Ganciclovir, foscarnet Viremia 50 In vivo expansion 28 d after T-cell transfer 600 CMV copies/mL blood Clearance of CMV from urine and throat until d 64, viremia until d 106 after SCT Follow-up until d 650 
6 Ganciclovir, foscarnet Pneumonia, viremia 146 Specific T cells undetectable after T-cell transfer 2 log decrease of CMV viremia delayed pulmonary toxicity syndrome d 172 after SCT Succumbed d 26 
7 valganciclovir Viremia 102 In vivo expansion 28 d after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Follow-up until d 56 
8 Ganciclovir Viremia 60 In vivo expansion 14 d after T-cell transfer Viremia Sepsis, heart failure d 79 after SCT Succumbed d 19 
9 Valganciclovir Dyspnea, diarrhea, fatigue, viremia 212 In vivo expansion 14 d after T-cell transfer Negative CMV PCR in blood, throat, and stool CMV reactivation after high-dose methylprednisolone at d 251 after SCT Last observation d 409 
10 Ganciclovir, cidofovir Pneumonia, viremia 19 In vivo expansion 8 d after T-cell transfer pp65 negative in peripheral blood; < 600 CMV DNA copies/mL blood Renal failure and respiratory failure d 45 after SCT Succumbed d 26 
11 Foscarnet, ganciclovir, cidofovir Encephalitis, cerebrospinal fluid, viremia 137 Transient in vivo expansion 10 d after T-cell transfer Negative CMV PCR in blood Clearance of CMV infection Follow-up until d 145 
12 Ganciclovir, foscarnet, cidofovir Reactivation since d 76 after SCT 116 Specific T cells undetectable after T-cell transfer Transient reduction of pp65 viremia cGVHD, upper GIT hemorrhage Follow-up until d 21 
13 Ganciclovir, foscarnet 3× CMV reactivation under treatment 64 In vivo expansion d 7 after T-cell transfer up to 3.6% at d 60 Clearance of pp65 viremia d 26 after T-cell transfer Clearance of CMV infection, no further ganciclovir treatment Follow-up until d 130 
14 Ganciclovir, foscarnet, cidofovir Blood 156 In vivo expansion 10 d after T-cell transfer 2 log decrease of CMV viremia Clearance of CMV infection Last observation d 112 
15 Ganciclovir, foscarnet Blood, urine 70 Viability of tested samples too low after transport Clearance of viremia d 14 after T-cell transfer No further CMV reactivation for 3 mo after T-cell transfer Last observation d 201 
16 Ganciclovir, foscarnet, cidofovir Blood, fatigue, diarrhea 199 In vivo expansion d 11 after T-cell transfer Clearance of CMV infection No further CMV reactivation for 2 mo after T-cell transfer Follow-up until d 390 
17 Ganciclovir, foscarnet, cidofovir Pneumonia, colitis, viremia 60 Transient in vivo expansion d 16 after T-cell transfer Transient reduction of viral load 1 log d 16 after T-cell transfer Died in multiorgan failure, mainly pneumonia 4 wk later Succumbed d 28 
18 Valganciclovir, foscavir, cidofovir Blood 70 In vivo expansion d 28 after T-cell transfer 2 log decrease of CMV viremia Clearance of CMV below threshold 6 wk after T-cell transfer Follow-up until d 220 

PCR indicates polymerase chain reaction; CSF, cerebrospinal fluid; cGVHD, chronic graft-versus-host disease; and GIT, gastrointestinal tract.

*

Mean day after SCT, 118 ± 71.

†

Mean last observation day after T-cell transfer, 173.

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