• Generation of Epstein-Barr virus-specific cytotoxic T-cell lines from bone marrow transplantation (BMT) donors [ Designated as safety issue: No ]
  
• Safety of one intravenous injection of BMT donor-derived EBV-specific cytotoxic T lymphocytes (CTLs) in BMT recipients at high risk [ Designated as safety issue: Yes ]
  
• Comparison of the antiviral and immunological efficacy of a single dose of CTLs vs the multiple dose regimens previously employed [ Designated as safety issue: Yes ]
  

OBJECTIVES:

• To generate Epstein-Barr virus (EBV)-specific cytotoxic T-cell lines from bone marrow transplantation (BMT) donors.
• To determine the safety of one intravenous injection of BMT donor-derived EBV-specific cytotoxic T lymphocytes (CTLs) in BMT recipients at high risk.
• To compare the antiviral and immunological efficacy of a single dose of CTLs versus the multiple dose regimens previously employed.

OUTLINE: Patients receive an infusion of Epstein-Barr Virus (EBV)-specific T cells on or after day 45 of an allogeneic stem cell transplantation regimen. EBV DNA persistence in peripheral blood is monitored by polymerase chain reaction before and after the infusion. Patients with EBV DNA levels above 1000 copies/μg or with persistent disease may receive up to 5 additional infusions of cytotoxic T lymphocytes (CTLs). Treatment repeats every 6 weeks in the absence of unacceptable toxicity.

Patients undergo blood sample collection periodically for immunophenotyping and tetramer analysis, assessment of EBV DNA content, and for reactivation of EBV-specific CTL lines to analyze specificity.

After completion of study treatment, patients are followed weekly for 6 weeks and then every 3 months for up to 1 year.

DISEASE CHARACTERISTICS:

• Meets 1 of the following criteria:

  • Receiving a T-cell depleted bone marrow transplantation from a mismatched family member or unrelated donor

  • Receiving a matched sibling transplantation or T-replete transplantation AND meets the following criteria:

    • At high risk of developing Epstein-Barr virus lymphoproliferative disease (EBV LPD) due to 1 of the following conditions:

      • Underlying disease (e.g., Wiskott-Aldrich syndrome or ataxia telangiectasia)
      • Past history of EBV LPD or other EBV-associated malignancy

PATIENT CHARACTERISTICS:

• Life expectancy ≥ 6 weeks
• No graft-versus-host disease ≥ grade 2
• No severe renal disease (i.e., creatinine clearance < half normal for age)*
• No severe hepatic disease (i.e., bilirubin > 2 times normal OR SGOT > 3 times normal)*
• No severe intercurrent infection NOTE: *Patients who would be excluded from the protocol strictly for laboratory abnormalities may be included at the investigator's discretion after approval by the CCGT Protocol Review committee and the FDA reviewer

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics