Limited antiviral effect of T-cell therapy in a patient receiving high-dose corticosteroids.

Patient no. 8 demonstrated an impressive expansion of CMV protein-specific CD4⁺ T cells after T-cell transfer associated with recovery of CMV peptide-specific CD8⁺ T cells already on day +10 after T-cell therapy and clearance of the viral DNA from the blood. After initiation of high-dose corticosteroid treatment for relapse of the underlying disease, a rapid increase of the virus load was observed. Peptide- and protein-specific T cells were analyzed by intracellular IFN-γ staining by flow cytometry after specific stimulation. Virus load was assessed by quantitative PCR (determined as virus copies/mL blood). The line represents the CMV-DNA load in the blood (virus copies/mL blood), the dark bars represent the number of circulating CMV protein-specific CD4⁺ T cells, and the gray bars represent the number/μL blood of circulating CD8⁺ T cells specific for the GPISHGHVLK CMV peptide, which represents the immunodominant epitope in HLA A*1101-positive individuals.