SUMMARY 
Patients who receive bone marrow transplants from a mismatched or unrelated donor have 
a high risk of morbidity and mortality from viral infection during the period of immune 
deficiency which follows the procedure. One such problem that occurs in these patients is 
EBV lymphoproliferation due to outgrowth of EBV infected B cells that would normally be 
controlled by EBV specific cytotoxic T cells. This complication occurs in 5-30% of recipients 
of mismatched or unrelated transplants and is almost invariably fatal. 
One possible approach to preventing this significant complication is to adoptively transfer 
EBV specific T cells from the BMT donor during the period when the recipient is at risk 
after the transplant. In this protocol we plan to evaluate this approach in a Phase I dose 
escalation study. Spontaneous lymphoblastoid cell lines which express the same range of 
EBV encoded proteins will be established at the time of confirmatory tissue typing and used 
as stimulator cells to derive EBV specific CTLs from donor blood obtained at the time of 
bone marrow harvest. Resulting cell lines will be characterized for EBV specificity and 
marked with the neomycin resistance gene. Marking these cells with the neomycin resistance 
gene is an important part of the study as it will allow us to learn how long these cells survive 
in the patient and whether expansion occurs in vivo. This information will be important in 
determining if the cells persist long enough to potentially confer protection and in 
determining appropriate doses and administration schedules. 
[1941 
Recombinant DNA Research, Volume 17 
