Document 2805
 DOCN  M94A2805
 TI    Immunotherapy with autologous HIV-specific CTL.
 DT    9412
 AU    Lieberman J; Fabry JA; Skolnik PR; Parkerson GR; Fong DM; Kagan J;
       Standiford H; Lee E; Landry B; New England Medical Center, Boston, MA
       02111.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):220 (abstract no. PB0311). Unique
       Identifier : AIDSLINE ICA10/94369770
 AB    OBJECTIVE: To test the feasibility, safety and tolerance of treating
       patients with CD4 counts of 100-400/mm3 by infusion of HIV-specific CTL
       in an attempt to bolster host immunity to control the virus. METHODS:
       The CTL response to HIV-1 is dominated by the recognition of a small
       number of peptides encoded by HIV-1 structural and regulatory genes. We
       are able to expand selectively HIV-specific CTL ex vivo by culture with
       autologous antigen-presenting cells preincubated with immunodominant
       HIV-1 peptides. In this pilot trial, groups of 5-8 patients are treated
       by a single infusion of 1 or 5 billion CTL, selectively expanded to
       recognize and lyse HIV-expressing targets, and followed for 6 months as
       to clinical course, T cell counts, viral burden in the blood, surrogate
       markers of infection and HIV-specific cellular immunity. RESULTS: In the
       first 9 patients followed for up to 6 months, no toxicity was associated
       with the infusion. Preliminary data reveal a rise in HIV-specific
       peripheral blood CTL in most patients. Following treatment some patients
       show CTL activity to previously unrecognized HIV proteins. Data will be
       presented about changes in viral titers in the peripheral blood as well
       as in surrogate markers of disease including CD4 counts. CONCLUSIONS:
       Immunotherapy with ex vivo-expanded autologous HIV-specific CTL is safe
       and feasible. Because of preliminary encouraging results, we are
       currently planning to reinfuse treated patients and to treat another
       cohort with multiple infusions.
 DE    *Blood Transfusion, Autologous  Cells, Cultured/TRANSPLANTATION  Cohort
       Studies  Feasibility Studies  Follow-Up Studies  Human  HIV
       Infections/IMMUNOLOGY/*THERAPY  HIV-1/*IMMUNOLOGY  Immunodominant
       Epitopes/IMMUNOLOGY  *Immunotherapy, Adoptive  Leukapheresis  Leukocyte
       Count  Pilot Projects  Safety  T-Lymphocytes,
       Cytotoxic/IMMUNOLOGY/*TRANSPLANTATION  T4 Lymphocytes  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).