Autologous lymphokine-activated killer cell therapy of Epstein-Barr virus-positive and -negative lymphoproliferative disorders arising in organ transplant recipients

Michael A. Nalesnik, Abdul S. Rao, Hiro Furukawa, Si Pham, Adriana Zeevi, John J. Fung, George Klein, H. Albin Gritsch, Elaine Elder, Theresa L. Whiteside, Thomas E. Starzl

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93 Scopus citations

Abstract

Lymphoreticular malignancies, collectively called posttransplant lymphoproliferative disorders (PTLD), eventually develop in 2-5% of organ transplant recipients. They frequently undergo regression when immunosuppression is reduced or stopped. This feature has been associated with a previous or de novo Epstein-Barr virus (EBV) infection. We herein describe immunotherapy with autologous lymphokine-activated killer (LAK) cells in seven patients with PTLD (four EBV-positive patients and three EBV- negative patients). Autologous peripheral blood mononuclear cells were obtained by leukapberesis, depleted of monocytes, and cultured in the presence of interleukin 2 for 10 to 11 days. A single dose of 5.2x109 to 5.6x1010 LAK cells was given intravenously. Systemic interleukin 2 was not administered. The four patients with EBV+ PTLD had complete tumor regression; two of them developed controllable rejection. Three patients are well 13-16 months after treatment; the fourth patient died of pneumonia 41 days after infusion. Three patients with EBV- lymphomas had no response despite prior evidence that their tumors also were subject to immune surveillance. Two of these three patients died after being given other treatment, and the third patient has persistent tumor. In conclusion, autologous LAK cell infusion was effective for treatment of four EBV+ organ transplant recipients. LAK cell efficacy for three patients with EBV PTLD was not evaluable under the management circumstances in which this treatment was utilized.

Original languageEnglish
Pages (from-to)1200-1205
Number of pages6
JournalTransplantation
Volume63
Issue number9
DOIs
StatePublished - 15 May 1997
Externally publishedYes

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