A trial looking at T cell immunotherapy for lymphoproliferative disease associated with Epstein Barr virus (EBV), after an organ transplant

Cancer type:

All cancer types

Status:

Results

Phase:

Phase 2/3

This trial was looking at a new way to treat lymphoproliferative disease after an organ transplant.

Up to 1 in 10 people who have an organ transplant, such as a heart transplant, will develop post transplant lymphoproliferative disease (PTLD). PTLD is a tumour of B lymphocytes, a type of white blood cell. PTLD occurs when these cells grow uncontrollably to form a tumour.

PTLD is caused by a virus called Epstein Barr virus (EBV). Most adults carry EBV but it is kept under control by cells in the immune system called T cells. But after an organ transplant, patients have drugs to suppress their immune system to stop organ rejection. EBV can then become active and this can cause uncontrolled growth of B lymphocytes, which can lead to cancer.

The usual treatment for a cancer related to PTLD is to stop or reduce the drugs that suppress the immune system. This can slow or stop the growth of the cancer. But it increases the risk of organ rejection. Other treatments such as chemotherapy, radiotherapy or rituximab (Mabthera) are sometimes used, but they don’t always work very well.

This trial was looking at a treatment called T cell immunotherapy (or ‘cytotoxic T cells’ Open a glossary item ) for PTLD. The aim of the trial was to see if cytotoxic T cells were a safe and useful treatment for PTLD.

Summary of results

The research team found that cytotoxic T cells are a safe and useful treatment for some people with post transplant lymphoproliferative disease (PTLD) associated with Epstein Barr virus (EBV).

This trial recruited 33 people who had had organ transplants and had then developed PTLD. They had all had other treatment for PTLD already, but it hadn’t worked. This included a reduced dose of the immune suppressing drugs, chemotherapy, radiotherapy and rituximab.

Everyone taking part had treatment with cytotoxic T cells. The cytotoxic T cells were grown from healthy blood donors and then given to the patient through a drip into a vein, once a week for 4 weeks.

The research team looked at how the 33 people were doing 6 months after treatment and found that the PTLD had

Gone away completely in 14 people
Reduced by at least half in 3 people
Remained the same or increased in size in 16 people (5 of these people were too unwell to complete the treatment)

The research team concluded that using cytotoxic T cells in this way was a safe and useful treatment for PTLD.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.