T time for transplants

Abstract

In allogeneic stem cell transplantation, unsorted donor T cells are dangerous things: too many and the recipient runs the risk of death from severe graft-versus-host disease (GVHD); not enough and the graft may fail, the disease recur, and opportunistic infection arise. Smarter, more specific donor T cells might be better, but how specific does specific need to be to avoid trouble? In this issue of Blood, Melenhorst and colleagues allay anxieties about the use of virus-specific donor-derived T cells to prevent or treat viral reactivation and infection occurring after allogeneic transplantation.1 Their analysis of 153 transplant recipients given virus-specific donor-derived cells showed no de novo GVHD secondary to adoptive transfer and a rate of GVHD reactivation of only 6.5% with no reactivation greater than grade II in severity.