LMP-specific T-cells for Patients With Relapsed EBV-positive Lymphoma (ALCI)

• Safety of 2 intravenous injections of autologous or allogeneic LMP-specific cytotoxic T-lymphocytes (CTL) in patients with relapsed Hodgkin's or non-Hodgkin's lymphoma. [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
  
• To determine the survival and the immune function of LMP-specific cytotoxic T-lymphocyte lines. [ Time Frame: 5 years ] [ Designated as safety issue: No ]
  
• To assess the anti-viral and anti-tumor effects of LMP-specific CTL. [ Time Frame: 5 yearas ] [ Designated as safety issue: No ]
  
• To obtain preliminary information on the safety and response to an extended dosage regimen [ Time Frame: 5 years ] [ Designated as safety issue: Yes ]
  

We will first test a biopsy of the tumor or lymph node that has already been done to see if the tumor or tissue cells are EBV positive. If the patient is eligible, we will then take 60 of blood from the patient or their donor on one or two occasions. We will use this blood to grow T cells. We will first grow special type of cells called dendritic cells or monocytes which will stimulate the T cells and we will put a specially produced human viruses that carries the LMP genes into the dendritic cells or monocytes. They will then be used to stimulate T cells. This stimulation will train the T cells to kill cells with LMP on their surface. We will then grow these LMP specific CTLs by more stimulation with EBV infected cells. These EBV infected cells will be treated with radiation so they cannot grow.

Once we have made sufficient numbers of T cells we will test them to make sure they kill cells with LMP on their surface. If the counts are low we may need to obtain additional blood samples to make these cells.

Prior to giving the patient the CTLs we will test the cells to make sure they don't attack the tissue.

The cells will then be thawed and injected into the patient over 10 minutes, after pretreatment with Tylenol and Benadryl. Tylenol and Benadryl are given to prevent a possible allergic reaction to the T cell administration. Initially, two doses of T cells will be given two weeks apart. If after the second infusion there is a reduction in the size of the lymphoma on CT or MRI scan as assessed by a radiologist, the patient can receive up to six additional doses of the T cells if the patient wishes. This is a dose escalation study which means that for some patients the second dose may be larger than the first. All of the treatments will be given by the Center for Cell and Gene Therapy at Texas Children's Hospital or the Methodist Hospital.

We will follow the patient after the injections. The patient will either be seen in the clinic or they will be contacted by a research nurse yearly for 5 years. To learn more about the way the T cells are working in the body, an extra 20-40 mls of blood will be taken before each infusion and then 4 hours after each infusion(optional), 3-4 days after each infusion (optional) and then weekly for 2 weeks after each infusion (total of 9 times). Two weeks after the last infusion, blood will then be taken again and then every 3 months for 1 year, then once a year for 5 years. We will use this blood to see how long the T cells last and to look at the immune response to the cancer.