A Pilot Study in the Treatment of Refractory Cytomegalovirus (CMV) Infections With Related Donor CMV Specific Cytotoxic T-cells (CTLs) in Children, Adolescents and Young Adult Recipients
CMV cytotoxic T cells (CTLs) manufactured with the Miltenyi CliniMACS Prodigy Cytokine Capture System will be administered in children, adolescents and young adults (CAYA) with refractory cytomegalovirus (CMV) infection post Allogeneic Hematopoietic Stem Cell Transplantation (AlloHSCT), with primary immunodeficiencies (PID) or post solid organ transplant. Funding Source: FDA OOPD
‣ 1\. Patients with refractory CMV infection post allogeneic HSCT, with primary immunodeficiencies or post solid organ transplant with either
• Increasing or persistent quantitative qRT-PCR DNA copies despite two weeks of appropriate anti-viral therapy AND/OR
• Medical intolerance to anti-viral therapies including:
• ANC \< 500/mm2 secondary to ganciclovir
⁃ 2 renal toxicity with foscarnet And/or
• known resistance to ganciclovir and/or foscarnet
‣ Consent: Written informed consent given (by patient or legal representative) prior to any study-related procedures.
‣ Performance Status \> 30% (Lansky \< 16 yrs and Karnofsky \> 16 yrs) Age: 0.1 to 79.99 years Females of childbearing potential with a negative urine pregnancy test
‣ Donor Eligibility Related donor available with a T-cell response to the CMV MACS® GMP PepTivator antigen(s).
‣ a. Third Party Allogeneic Donor: If original donor is not available or does not have a T-cell response: third party related allogeneic donor (family donor \> 1 HLA A, B, DR match to recipient) with IgG positive to CMV and/or a T-cell response to the CMV MACS® GMP PepTivator .
‣ AND Allogeneic donor disease screening is complete similar to hematopoietic stem cell donors (Appendix 1).
‣ AND Obtained informed consents by donor or donor legally authorized representative prior to donor collection.