Donor Cytomegalovirus-Specific Cytotoxic T-Lymphocytes in Treating Patients With a Persistent Cytomegalovirus Infection

This is an interventional treatment trial for Cytomegaloviral Infection Read More

Inclusion Criteria:

• Patients with or without a malignancy; and/or any type of autologous or allogeneic HSCT; and/or patients who are immunocompromised with CMV infection will be included

• Persistent CMV infection despite optimum anti-viral therapy

  • Patients with CMV disease: defined as the demonstration of CMV by biopsy specimen from visceral sites (by culture or histology) or the detection of CMV by culture or direct fluorescent antibody stain in bronchoalveolar lavage fluid in the presence of new or changing pulmonary infiltrates; OR

  • Failure of antiviral therapy: defined as the continued presence of deoxyribonucleic acid (DNA)emia (defined as >= 137 copies/ml by polymerase chain reaction [PCR]) for at least 2 weeks of CMV antiviral therapy; OR

    • Optimum therapy is defined as at least 14 days of therapy with ganciclovir, foscarnet, cidofovir, or valganciclovir for patients with disease or CMV viremia
    • Relapse while on CMV antiviral therapy defined as recurrence of DNAemia while being on at least 2 weeks of antiviral therapy OR
  • Patients who cannot tolerate standard anti-viral therapy and cannot continue anti-viral treatment due to side effect profile will be eligible independent of anti-viral therapy duration
• Clinical status at enrollment to allow tapering of steroids equal to or less than 0.5 mg/kg/day of prednisone
• Patients with chronic graft-versus-host disease (GVHD) if on prednisone equal to or less than 0.5 mg/kg and not receiving second-line GVHD treatments like pentostatin, infliximab, etanercept, etc
• Written informed consent and/or signed assent line from patient, parent or guardian
• Negative pregnancy test in female patients of childbearing potential

Exclusion Criteria:

• Patients receiving prednisone > 0.5 mg/kg/day at time of enrollment, or have received anti-thymocyte globulin (ATG), donor lymphocyte infusion (DLI) or Campath within 28 days of enrollment
• Patients with other uncontrolled infections; for bacterial infections, patients must be receiving definitive therapy and have no signs of progressing infection for 72 hours prior to enrollment; for fungal infections patients must be receiving definitive systemic anti-fungal therapy and have no signs of progressing infection for 1 week prior to enrollment; progressing infection is defined as hemodynamic instability attributable to sepsis or new symptoms, worsening physical signs or radiographic findings attributable to infection; persisting fever without other signs or symptoms will not be interpreted as progressing infection; patients with ongoing viral infections are excluded
• Patients with active acute GVHD grades II-IV
• Active and uncontrolled relapse of malignancy