title: [Cellular sorting methods in autologous (elimination of residual malignant cells) or allogeneic (T lymphocyte elimination) bone marrow grafts. Clinical pilot studies].
abstract: Ex vivo bone marrow treatment prior to autologous bone marrow transplantation for acute leukemia or solid tumors (known for their frequent medullary metastatic dissemination) has provoked a great deal of hope and enthusiasm. If, as in most cases, the feasibility of various methods (exposure to chemical products, monoclonal antibodies and complement-dependent cytolysis, immuno-magnetic procedures) has been confirmed, no study to date has shown the efficacy. Only randomized studies will result in such a proof, on the condition that all the specific technical parameters of each method have been perfectly defined. The clinical results of pilot evaluation studies for the prevention of graft-versus-host reaction through the elimination of T lymphocytes in the donor graft have been encouraging. They have shown the feasibility and efficacy of different methods of T cell depletion. One point however remains controversial: is it necessary or not to eliminate all T lymphocytes? After a depletion which is too efficient, the difficulties involved in grafting the donor's hematopoietic cells on the recipient represent a new problem, e.g., in allogenic grafts for acute leukemia (host-versus-graft). In order to resolve the problem of these take failures (10 to 20% of the published series except for Royal Free Hospital and Besançon) it appears necessary to redefine the conditioning regimen prior to allogenic bone marrow transplantation.
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000951:Antigens, Neoplasm / Q000627:therapeutic use; D001853:Bone Marrow / Q000187:drug effects; D001854:Bone Marrow Cells; D016026:Bone Marrow Transplantation; D002469:Cell Separation / Q000379:methods; D002499:Centrifugation, Density Gradient; D003520:Cyclophosphamide / Q000031:analogs & derivatives / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006801:Humans; D037102:Lectins / Q000627:therapeutic use; D007938:Leukemia / Q000628:therapy; D008212:Lymphocyte Depletion; D008775:Methylprednisolone / Q000627:therapeutic use; D009369:Neoplasms / Q000628:therapy*; D015260:Neprilysin; D010865:Pilot Projects; D037121:Plant Lectins; D012276:Ricin / Q000627:therapeutic use; D030262:Soybean Proteins; D013601:T-Lymphocytes; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D010835:Phytohemagglutinins
chemical_list: D000911:Antibodies, Monoclonal; D000951:Antigens, Neoplasm; D003520:Cyclophosphamide; D037102:Lectins; D008775:Methylprednisolone; D015260:Neprilysin; D037121:Plant Lectins; D012276:Ricin; D030262:Soybean Proteins; C028824:soybean lectin; D010835:Phytohemagglutinins; C037933:Asta Z 7557; C011272:perfosfamide
vernacular_title: Les méthodes de tri cellulaire au cours des greffes de moelle osseuse autologue (élimination des cellules malignes résiduelles) ou allogéniques (élimination des lymphocytes T). Essais cliniques pilotes.