Extensive vitiligo after ganciclovir treatment of GvHD in a patient who had received donor T cells expressing herpes simplex virus thymidine kinase

The Lancet ◽  
2000 ◽  
Vol 355 (9204) ◽  
pp. 626-627 ◽  
Author(s):  
F Aubin ◽  
JY Cahn ◽  
C Ferrand ◽  
R Angonin ◽  
P Humbert ◽  
...  
2003 ◽  
Vol 14 (4) ◽  
pp. 341-351 ◽  
Author(s):  
Sebastianus Kolen ◽  
Mo Weijtens ◽  
Anton Hagenbeek ◽  
Anke van Spronsen ◽  
Saskia Smulders ◽  
...  

Blood ◽  
2001 ◽  
Vol 97 (1) ◽  
pp. 122-129 ◽  
Author(s):  
Marina I. Garin ◽  
Elaine Garrett ◽  
Pierre Tiberghien ◽  
Jane F. Apperley ◽  
David Chalmers ◽  
...  

Abstract The herpes simplex virus thymidine kinase gene type 1 (HSV-Tk) ganciclovir (GCV) system is a novel therapeutic strategy for the modulation of graft-versus-host disease (GVHD), a major complication of allogeneic stem cell transplantation (allo-SCT). Retroviral-mediated gene transfer of the HSV-Tk gene into donor T lymphocytes before allo-SCT may allow their in vivo selective depletion after treatment with GCV. The expression of theHSV-Tk gene was analyzed in vitro in CEM cells, a human lymphoblastoid cell line, transduced with 2 different vectors, each containing the HSV-Tk gene and a selectable marker gene. GCV-resistant clones were identified within the clones expressing the marker gene. Characterization of the molecular events leading to this resistance revealed a 227-bp deletion in the HSV-Tk gene due to the presence of cryptic splice donor and acceptor sites within the HSV-Tk gene sequence. Furthermore, it was confirmed that this deletion was present in human primary T cells transduced with either vector and in 12 patients who received transduced donor T cells, together with a T-cell–depleted allo-SCT. In vivo circulating transduced T cells containing the truncated HSV-Tk gene were identified in all patients immediately after infusion and up to 800 days after transplantation. In patients who received GCV as treatment for GVHD, a progressive increase in the proportion of transduced donor T cells carrying the deleted HSV-Tkgene was observed. These results suggest that the limitations within the HSV-Tk/GCV system can be improved by developing optimized retroviral vectors to ensure maximal killing ofHSV-Tk–transduced cells.


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