Residual clonable host cell detection for predicting engraftment of T cell depleted BMTs.
Rejection of T-depleted BMTs is predominantly mediated by alloreactive host T cells. A low but significant number of radiochemoresistant clonable T cells can be detected following a conventional cytoreductive protocol given prior to T-depleted BMT. Elimination of these cells increases the engraftment rate. We found no clonable T cells at the end of the conditioning regimen in 100 ml of peripheral blood from 47 patients who received an HLA-identical T-depleted BMT. None rejected the graft and none displayed mixed chimerism. In addition, although no clonable T cells were detected in nine patients who received a mismatched BMT, two rejected their graft. However, in three mismatched patients, who for clinical reasons received a modified pre-BMT schedule, the presence of host clonable T cells was associated with immunological rejection. These findings suggest that the detection of clonable T cells should prove a valuable indicator for optimising immunosuppression prior to T-depleted BMT.
Department of Haematology, Perugia University, Italy.
A
A
Terenzi
F
F
Aversa
N
N
Albi
R
R
Galandrini
C
C
Dembech
A
A
Velardi
M F
MF
Martelli
D000293:Adolescent; D000328:Adult; D016465:Bone Marrow Purging; D016026:Bone Marrow Transplantation / Q000276:immunology*; D002648:Child; D003601:Cytotoxicity Tests, Immunologic; D005260:Female; D006084:Graft Rejection / Q000097:blood / Q000209:etiology / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D013601:T-Lymphocytes / Q000276:immunology*
D006680:HLA Antigens