Investigators urge careful monitoring for HHV-6 and ciHHV-6.
Part 2: CAR-T cell therapy and its complications
Could some complications of CAR-T cell therapy be secondary to HHV-6 infection?
Part 3. HHV-6 Encephalitis in CAR-T Cell therapy
Clearly documented cases of HHV-6 encephalitis have been reported, but some are missed because they were classified as ICAN or because HHV-6 testing was not performed in patients with mental status changes.
Part 4. Might HHV-6 contribute to some cases of cytokine release syndrome, pneumonia, and cytopenias in CAR-T Cell therapy?
While unlikely to trigger the cytokine storm, HHV-6 infection may perpetuate it, and contribute directly to cytopenias and pneumonia.
Early HHV-6 specific T-cell responses by ELISpot were remarkably higher in alloHSCT patients who went on to develop clinically relevant infections
T-cell responses correlate directly with clinical symptoms, and were better predictors of HHV-6 disease than viral load or total CD3+ counts.
Increased expression of HHV-6B receptor CD134/OX40 found in DIHS/DRESS skin lesions
The severity of DIHS/DRESS cases was significantly correlated with the frequency of CD134+ cells.
Short-course foscarnet at an early stage may suppress HHV-6 reactivation following allogenic HCT
Observational study suggests that an early one-week treatment at the first sign of viral reactivation may achieve clinical benefits and avoid antiviral toxicity.
High levels of HHV-6A DNA found in blood of 52% of kidney transplant patients
HHV-6A was the most common virus identified, but was not linked to worse outcomes compared to other viral infections.
Small study finds relatively high foscarnet concentrations in CSF in HHV-6 encephalitis
CSF foscarnet concentrati.ons were very near IC50 and were followed by sharp reductions in viral load.
German HCT specialists call for iciHHV-6 screening of patients and donors
Study finds value in HHV-6 testing of other tissues, as well as blood, and of routine testing for iciHHV-6 in both donors and recipients of allo-HCT.
Herpesvirus reactivation during alloHSCT associated with greatly increased mortality and expense
Data from 13,363 transplant patients underline the importance of preventing, diagnosing and treating viral reactivation.
Virus specific T cell infusions show promise for preventing HHV-6B reactivation in transplant patients
Review highlights the importance of cell mediated immunity and the limitations of antivirals, vaccines and immunoglobulin therapy for HHV-6, VZV and HSV.
Reference values established for virus specific T-cells in healthy adults
These values may help determine the type of treatment transplant patients should receive: antiviral or adoptive T-cell therapy or a reduction in immunosuppression.
HHV-6 encephalitis following CAR-T cell therapy
A growing number of case reports reveal reactivation similar to that seen after hematopoietic stem cell therapy. Could CAR-T cells be a source of lytic HHV-6?
Adding an adoptive NK cell infusion to naïve T-Cell-depleted grafts may reduce the rate of HHV-6B reactivation and encephalitis
A small pediatric study found that adoptive NK cell infusions eliminated HHV-6B encephalitis, while maintaining a low rate of GVHD. At a ratio of NK/CD4 >2, the HHV-6B reactivation rate dropped dramatically.