AUTHOR=Su Nan , Liu Zhenghua , Sun Peng , Gu Feng , Yan Xiaojing , Cai Dali 

TITLE=Donor-derived cytomegalovirus-cytotoxic T lymphocytes and leflunomide successfully control refractory cytomegalovirus infections and disease of multiple sites after allogeneic-hematopoietic stem cell transplantation: A case report

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.948210

DOI=10.3389/fmed.2022.948210

ISSN=2296-858X

ABSTRACT=Drug-resistant CMV infection post HSCT often leads to morbidity and mortality. Several studies have shown that CMV-CTLs can overcome resistant CMV infection, but still many questions remain unanswered. Here we present a case of refractory CMV infection post allogeneic HSCT. Donor derived CMV-CTLs failed to eliminate the virus in unique peripheral blood on the first application, when 70mg methylprednisolone was taken per day. After a second attempt with a combination of 8mg methylprednisolone with leflunomide, a complete and persisting clearance of all involved sites, including peripheral blood, urinary system, leptomeninges and retina was achieved . To summarize, intravenous infusion of CTLs can eliminate CMV in oculi and central nervous system and a low dosage of 8mg methylprednisolone has no interaction with CMV-CTLs.