CYTOMEGALOVIRUS (CMV) infection remains one of the most serious complications following hematopoietic stem cell transplant and solid organ transplant, with virus-specific T-cell therapy emerging as a potential strategy to reduce risk and improve outcomes. In a newly published scoping review, researchers evaluated the clinical use of CMV-specific T cells (CMV-VSTs) in both prophylactic and treatment settings, revealing key trends in efficacy and safety among transplant patients.
The review systematically examined 67 studies out of 2587 identified abstracts, focusing on those using CMV-VSTs in transplant recipients. Most of the evidence came from the hematopoietic stem cell transplant population, where the use of VSTs as a preventative measure was associated with a CMV infection rate of 28% (interquartile range [IQR] 14–44). For patients with non-refractory or resistant CMV infections, the response rate was an impressive 98% (IQR 70–100). In cases of refractory or resistant infections specifically, the response rate dropped slightly to 70% (IQR 56–88).
By contrast, data in solid organ transplant recipients were far more limited. Only four studies reported on this group, with response rates ranging from 15% to 64% in patients with refractory or resistant infections. Across all studies, researchers noted inconsistent reporting of crucial variables such as donor and recipient serostatus, antiviral usage, and definitions of CMV response, limiting the ability to draw broader conclusions.
Importantly, CMV-VST therapy appeared to be well-tolerated, with minimal adverse events reported across the studies reviewed. The authors emphasize the need for a standardized registry and more uniform study design moving forward, including better characterization of optimal dosing, timing, and interactions with concurrent antiviral therapy.
These findings underscore both the promise and current limitations of virus-specific T-cell therapy as a tool for managing CMV in transplant settings. With further refinement and structured data collection, CMV-VSTs could play a transformative role in post-transplant care.
Reference:
Fung JST et al. Virus-specific T-cell therapy for prophylaxis and treatment of cytomegalovirus infections after transplantation: a scoping review. Clin Infect Dis. 2025:ciaf232.
