Dr Farid on the Clinical Utility of Tabelecleucel in R/R EV+ PTLD

“This case highlights the promising treatment option of tabelecleucel in the relapsed/ refractory setting, which is very, very difficult to handle due to the very rapid progression of disease. [Tabelecleucel] is an off-the-shelf allogeneic T-cell therapy, and it addresses this problem really nicely.”

Kiavasch Mohammad Nejad Farid, MD, of Heidelberg University Hospital, discussed the clinical utility of the EBV-specific allogeneic T-cell therapy tabelecleucel in the management of relapsed/refractory post-transplant lymphoproliferative disorder (PTLD), particularly in patients with rapid disease progression following hematopoietic cell or solid organ transplantation.

In this context, tabelecleucel serves as an off-the-shelf, allogeneic T-cell immunotherapy designed to restore immune surveillance by providing Epstein-Barr virus (EBV)–specific T cells capable of targeting and controlling EBV-driven lymphoproliferation.

Farid emphasized that managing PTLD in the relapsed/refractory setting remains challenging due to its aggressive clinical course and limited therapeutic options, particularly in patients who are refractory to rituximab (Rituxan)-based regimens or are ineligible for intensive cytotoxic therapy. In such cases, durable responses are often predicated on the ability to re-establish effective immune surveillance. Tabelecleucel offers a non-cytotoxic, immunologically targeted approach that directly addresses this underlying pathophysiology by supplementing the deficient T-cell–mediated response to EBV antigens.

The case study shared by Farid underscores the therapeutic potential of tabelecleucel in this patient population, yet he acknowledged that further research is warranted to clarify its optimal integration into the broader treatment landscape of PTLD. Notably, consideration must be given to concurrent complications commonly encountered in this patient population, including graft-vs-host disease, opportunistic infections, and the logistical challenge of matching patients with HLA-restricted tabelecleucel products.

Real-world cases, such as the one discussed by Farid, provide important clinical insight into the feasibility, safety, and efficacy of tabelecleucel in highly complex scenarios. These data are instrumental in guiding future efforts to refine treatment algorithms and inform patient selection. Farid noted that although tabelecleucel represents a significant step forward in addressing the immune dysfunction inherent to EBV-associated PTLD, standardized protocols and expanded manufacturing capabilities are necessary to ensure broader clinical accessibility.