Allogeneic bone marrow transplantation for adult leukaemia with soy bean lectin fractionated marrow.
A heterogeneous group of 11 consecutive patients with leukaemia have been transplanted successfully with allogeneic marrow depleted of T lymphocytes by soy bean lectin agglutination and neuraminidase-treated sheep erythrocyte rosetting. Effective depletion was achieved, leaving less than 1% of donor T lymphocytes. Despite the small numbers of nucleated cells infused (mean 0.14 X 10(8)/kg) there was only moderately delayed recovery of peripheral blood counts and no graft failures have occurred. Standard methotrexate prophylaxis against graft-versus-host disease (GVHD) was also employed in the first four transplants. Only one case of mild grade I (skin only) acute GVHD has occurred and there has been no chronic GVHD to date. The group of patients show an actuarial cumulative survival of 55% with two early infective deaths (days 42 and 44 post-transplant) and three late deaths, two with leukaemic relapse and the third with probable viral encephalitis. The longest survivor is now 1109 days post-transplant. This series indicates that lectin fractionation of donor marrow, previously employed mainly in children, can also be effective in minimizing GVHD in adults without endangering successful engraftment.
Slocombe
G W
GW
Department of Haematology, London Hospital, UK.
Newland
A C
AC
Yeatman
N W
NW
Macey
M
M
Jones
H M
HM
Knott
L
L
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation; D002452:Cell Count; D002648:Child; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D006801:Humans; D007239:Infections / Q000209:etiology; D037102:Lectins; D007938:Leukemia / Q000150:complications / Q000628:therapy*; D008212:Lymphocyte Depletion / Q000379:methods; D008297:Male; D008875:Middle Aged; D037121:Plant Lectins; D012008:Recurrence; D030262:Soybean Proteins; D013025:Glycine max; D013601:T-Lymphocytes; D010835:Phytohemagglutinins
D037102:Lectins; D037121:Plant Lectins; D030262:Soybean Proteins; C028824:soybean lectin; D010835:Phytohemagglutinins