Immunotherapy against EBV-lymphoma in recipients of HSCT

Abstract

Epstein–Barr virus (EBV)-associated lymphoproliferations represent life-threatening complications of hematopoietic stem cell transplantation. In the last decade, immunological therapeutic strategies that allow us to selectively abrogate the origin of lymphoproliferation, namely B-cell compartment or EBV antigen-expressing tumor cells, have significantly reduced treatment-related toxicity while maintaining equal or superior efficacy. A further implementation is the possibility of preventing disease occurrence by delivering immunotherapy in the presymptomatic phase, on the basis of EBV-DNA blood levels. Despite the excellent results, T-cell therapy with EBV-specific cytotoxic T-lymphocytes has but a marginal role in the treatment of these forms. Promising implementations are underway, including logistic solutions to extend T-cell therapy beyond academic centers, delineation of strategies aimed at simplifying/shortening production and targeting immune evasion mechanisms exerted by tumor cells.

Keywords::

• allogeneic stem cell transplantation
• Epstein–Barr virus
• lymphoproliferative disease
• minimization of treatment-related toxicity
• monoclonal antibody therapy
• T-cell therapy

Financial & competing interests disclosure

This work has been partly supported by grants from AIRC (Associazione Italiana Ricerca sul Cancro) to Patricia Comoli; Ministero della Salute, Progetti Ricerca Oncologica number RFPS-2006-4-341763 to Patricia Comoli; number RFPS-2006-Regione Umbria to Patricia Comoli. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.