Adoptive T-cell therapy for virus-associated diseases

SUMMARYViral infections remain a significant and predictable challenge in solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients. Although antiviral drugs are commonly used for prophylaxis or early treatment, their long-term use is limited by toxicity, high costs, and the emergence of drug-resistant viral strains, often leading to treatment failure. Cellular immune therapies, particularly adoptive transfer of virus-specific T cells (VSTs), have emerged as a promising alternative, with proven efficacy in controlling hematological malignancies and severe viral infections. While donor-derived VSTs can effectively suppress viral replication in HSCT and SOT recipients, this approach is not feasible when donors are seronegative or inaccessible. A novel single-platform technology now allows for the rapid generation of multi-virus-specific T cells from healthy donors, broadening the applicability of this strategy. In addition, immune monitoring tools can help identify high-risk patients, enabling earlier and more targeted interventions. Emerging data suggest that adoptive T-cell therapy may be used not only therapeutically but also prophylactically, potentially replacing conventional antivirals and reducing adverse effects in immunocompromised patients. This review provides historical foundations and recent advancements in the use of adoptive T-cell therapies for virus-associated complications in transplant recipients.