[Clinical Observation of Donor-Derived NK Cell Infusion in the Prevention of Cytomegalovirus Infection after Haploidentical Hematopoietic Stem Cell Transplantation].
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OBJECTIVE: To observe the safety and clinical efficacy of adoptive infusion of donor-derived natural killer (NK) cells in the prevention of cytomegalovirus (CMV) infection after haploidentical hematopoietic stem cell transplantation (haplo-HSCT). METHODS: 18 patients who underwent haplo-HSCT were enrolled and received donor-derived peripheral blood NK cell infusion on the day of transplantation. 18 patients who had undergone haplo-HSCT without NK cell infusion in our department were included as controls. Vital signs and acute cell therapy-related toxicities were monitored during infusion and within 48 hours after infusion. The incidence of CMV infection from neutrophil engraftment to 3 months post-transplantation, the rate of acute graft-versus-host disease (GVHD), and survival status were documented. RESULTS: The dose of infused NK cells was (4.83±1.37)×107 cells/kg. Weight gain was seen in one patient after infusion and recovered with diuretic treatment. Three patients developed mild liver dysfunction and improved after medication. No patient showed symptoms of fever, rash, or capillary leak syndrome. Among the 18 patients in the NK cell infusion group, 7(38.9%) tested positive for CMV, which was significantly lower than 14(77.8%) in the historical control group (P<0.05). There was no statistically significant difference in the incidence of acute GVHD between the two groups. There were 4 deaths in the NK cell infusion group: 2 due to thrombotic microangiopathy, 1 due to hepatic veno-occlusive disease, and 1 due to leukemia relapse. Four patients died in the control group: 3 due to thrombotic microangiopathy, and 1 due to disease relapse. CONCLUSION: Co-infusion of donor-derived NK cells during haplo-HSCT is safe and well-tolerated and effectively decreases the incidence of post-transplant CMV infection, providing a novel strategy for CMV prophylaxis after transplantation.