Case Report: Cytomegalovirus-specific T-lymphocyte infusion for resistant cytomegalovirus retinitis

• Published in: Frontiers in ophthalmology 2023-07, Vol.3, p.1131674
• Main Authors: Saban, Tal, Shargian, Liat, Eiger-Moscovitch, Maya, Prockop, Susan, Doubrovina, Ekatarina, Yeshurun, Moshe, Kramer, Michal
• Format: Article
• Language: English
• Subjects: CMV retinitis; CMV-specific cytotoxic T lymphocytes; cytomegalovirus-specific T-lymphocyte; Ophthalmology; resistant CMV retinitis; T-lymphocytes infusion
• ISSN: 2674-0826; 2674-0826
• DOI: 10.3389/fopht.2023.1131674

We hereby describe a case of persistent cytomegalovirus (CMV) viremia and retinitis following allogeneic hematopoietic cell transplantation (HCT) that was successfully treated with infusion of CMV-specific cytotoxic T lymphocytes (CTL) despite previous treatment with Epstein Bar Virus (EBV) -specific CTL, which occurred 5 months earlier. Following several anti- viral medication treatment trials that failed to eradicate the infectious process, the patient was treated with infusions of CMV-CTL from a biobank of cryopreserved virus-specific cells. Shortly after the first infusion, a remarkable response was noted. A few days after the second infusion, the retinitis resolved completely. No recurrence was noted at the one-year follow-up, and there was no evidence of GVHD. The case is unique for two reasons: use of virus-specific CTL for an indication of CMV retinitis; and successive administration, in the same patient, of third-party virus-specific CTL to treat two different infections (Epstein-Barr virus and cytomegalovirus) on two separate occasions following hematopoietic cell transplantation.