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3.
Transplant Proc ; 39(1): 237-9, 2007.
Article in English | MEDLINE | ID: mdl-17275512

ABSTRACT

In association with the increased use of unrelated cord blood transplantation (UCBT) in adults, numerous patients have developed cytomegalovirus (CMV) reactivation concomitant with cytopenia. Although foscarnet appears to offer similar efficacy and higher safety as a preemptive therapy against CMV infection than ganciclovir, little is known about the usefulness of foscarnet in such patients. Foscarnet was administered as preemptive therapy against CMV antigenemia in 10 UCBT recipients who were unable to receive ganciclovir due to cytopenia or poor response to ganciclovir. Fatal CMV disease developed in one patient, whereas CMV antigenemia resolved without progression to CMV disease in the remaining nine patients. Foscarnet was well tolerated without serious hematotoxicity and was not discontinued due to adverse events in any patient. Foscarnet represents a safe and effective agent for preemptive therapy against CMV infection and may offer a feasible alternative to ganciclovir in UCBT recipients.


Subject(s)
Cord Blood Stem Cell Transplantation , Cytomegalovirus Infections/prevention & control , Foscarnet/therapeutic use , Antigens, Viral/blood , Antiviral Agents/therapeutic use , Bone Marrow Transplantation , Humans , Leukocyte Count , Neutrophils , Patient Selection , Recurrence , Treatment Outcome
4.
Bone Marrow Transplant ; 34(8): 703-9, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15322566

ABSTRACT

The immune system of females is capable of recognizing and reacting against the male-specific minor histocompatibility antigen (mHA), HY. Thus, cytotoxic T-lymphocytes (CTLs) recognizing this antigen may be useful in eradicating leukemic cells of a male patient if they can be generated in vivo or in vitro from a human leukocyte antigen (HLA)-identical female donor. The HLA-A*0201-restricted HY antigen, FIDSYICQV, is a male-specific mHA. Using HLA-A2/HY peptide tetrameric complexes, we reveal a close association between the emergence of HY peptide-specific CD8(+) T cells in peripheral blood and molecular remission of relapsed BCR/ABL(+) chronic myelogenous leukemia in lymphoid blast crisis in a patient who underwent female-to-male transplantation. Assessment of intracellular cytokine levels identified T cells that produce interferon-gamma in response to the HY peptide during the presence of HY tetramer-positive T cells. These results indicate that transplant with allogeneic HY-specific CTLs has therapeutic potential for relapsed leukemia, and that expansion of such T cells may be involved in the development of a graft-versus-leukemia response against lymphoblastic leukemia cells.


Subject(s)
Graft vs Leukemia Effect , Minor Histocompatibility Antigens/chemistry , Minor Histocompatibility Antigens/immunology , T-Lymphocytes/immunology , Adolescent , Antigens/chemistry , Blast Crisis , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , Cell Transplantation , Complementarity Determining Regions/chemistry , Cytokines/biosynthesis , DNA, Complementary/metabolism , Dose-Response Relationship, Drug , Female , Flow Cytometry , HLA-A Antigens/chemistry , HLA-A2 Antigen , Humans , Interferon-gamma/biosynthesis , Leukemia, Lymphoid/therapy , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism , Male , Peptides/chemistry , Polymerase Chain Reaction , Sex Factors , T-Lymphocytes/metabolism
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