1. Long-term outcome of a phase II study of BM transplants, partially depleted ex-vivo of CD5-positive and CD8-positive T-lymphocytes in unrelated and related donor 1 antigen mismatched recipients.
- Author
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Gajewski JL, Nimer S, Saliba RM, Thomas M, Przepiorka D, Giralt S, von Besien K, Mehra R, Andersson B, Chan KW, Ippoliti C, Warkinten D, Feigs S, Territo M, Schiller G, Lebkowski J, Moseley AM, Lloyd K, von Hoeff M, Okarma T, and Champlin R
- Subjects
- Adolescent, Adult, Bone Marrow Cells cytology, Child, Female, Follow-Up Studies, Graft vs Host Disease immunology, Graft vs Host Disease prevention & control, Histocompatibility, Humans, Leukemia therapy, Lymphoma therapy, Male, Recurrence, Treatment Outcome, Bone Marrow Transplantation methods, CD5 Antigens biosynthesis, CD8-Positive T-Lymphocytes metabolism
- Abstract
Background: Mismatched family donor and unrelated donor BM transplants are associated with a high risk of acute GvHD. White T-cell depletion is the best method to reduce risk of acute GvHD, there was a reluctance to use T-cell depletion in the mismatched setting because of increased risk of rejection and relapse. Partial T-cell depletion, by the panning of CDS and CD8 positive T cells may reduce complications related to GvHD without compromising outcomes., Method: In a long-term follow-up of a Phase II study of partial T-cell depletion by panning for BM transplant, 32 recipients received transplants from a single-Ag (HLA A, B, or DR) mismatched family donor; or an HLA serologically-matched unrelated donor. Patients were studied for engraftment, GHD, relapse and survival., Results: 30 (94%) of the patients marrow engrafted. The cumulative risk of Grade 2-4 acute GvHD was 62 - 9%; of Grade 3-4 GvHD, 11 - 6%. The 4-year cumulative risk of relapse was 18 - 8% and actuarial survival was 44 - 9%., Discussion: Partial T-cell depletion had a low rate of severe acute GvHD without compromising engrafment or relapse risk.
- Published
- 1999
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