T-cell depletion of allogeneic peripheral blood stem cells.
The high content of immunocompetent T-cells in apheresis products may expose recipients of allogeneic peripheral blood stem cells (PBSC) to an elevated risk of acute and chronic graft-versus-host disease (GvHD). Thus, the use of an appropriate T-cell reduction or depletion technique might reduce this risk. The hazards of rejection and of a higher relapse rate should be avoided by maintaining a portion of the T-cells in the graft or by increasing the number of transplanted stem cells. The positive selection of CD34+ cells from peripheral blood preparations simultaneously provides an approximately 1,000-fold reduction of T-cells. Purified CD34+ cells containing committed and pluripotent stem cells are suitable for allogeneic transplantation. In transplantation from HLA-mismatched or three HLA-loci different family donors the amount of stem cells can be increased for reducing the incidence of rejection without increasing the T-cell number. In cases of poor marrow graft function a 'boost' with stem cells from the same family donor can be given. The risk of GvHD in transplantation from volunteer-matched unrelated donors might be reduced by T-cell depletion. If T-cells are used for enhancing the graft-versus-leukaemia effect, CD34+ enriched cells can be given for haematopoietic engraftment.
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Department of Internal Medicine I, Westpfalz Medical Centre, Kaiserslautern, Germany.
D018952:Antigens, CD34 / Q000097:blood; D002469:Cell Separation / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D006086:Graft vs Host Disease / Q000517:prevention & control; D006412:Hematopoietic Stem Cells / Q000166:cytology* / Q000276:immunology; D006801:Humans; D008212:Lymphocyte Depletion / Q000706:statistics & numerical data*; D013601:T-Lymphocytes; D014184:Transplantation, Homologous / Q000009:adverse effects / Q000379:methods / Q000592:standards
D018952:Antigens, CD34