Impact of T-cell depletion on outcome of allogeneic bone-marrow transplantation for standard-risk leukaemias.
71 leukaemic patients having HLA-matched bone-marrow transplants (BMT) were randomised to receive whole marrow (group A) or marrow depleted of T cells by treatment with monoclonal antibodies (anti CD4-CD5-CD8, group B; anti CD2-CD5-CD7, group C) plus complement. All patients received cyclophosphamide and total body irradiation before transplantation and cyclosporin after BMT. Marrow treatment removed 97% of T cells (median) in group B and 99% in group C. Although both serious and mild graft-versus-host disease (GVHD) were reduced in T-cell depleted patients, graft failure and relapse were increased. Graft failure was caused by GVHD and transplant complications in the controls and by rejection and relapse in the T-cell depleted groups; relapse-free survival did not differ between the groups. Without better control of host immunity and of the residual leukaemia T-cell depletion of the marrow, BMT should not be pursued in standard-risk patients.
D000293:Adolescent; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002986:Clinical Trials as Topic; D003165:Complement System Proteins / Q000276:immunology; D003524:Cyclosporins / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000517:prevention & control; D006801:Humans; D066298:In Vitro Techniques; D007938:Leukemia / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D011897:Random Allocation; D012074:Remission Induction; D012306:Risk; D013601:T-Lymphocytes / Q000276:immunology
D000911:Antibodies, Monoclonal; D003524:Cyclosporins; D003165:Complement System Proteins