Long-term outcome of a phase II study of BM transplants, partially depleted ex-vivo of CD5-positive and CD8-positive T-lymphocytes in unrelated and related donor 1 antigen mismatched recipients.
BACKGROUND
Mismatched family donor and unrelated donor BM transplants are associated with a high risk of acute GvHD. White T-cell depletion is the best method to reduce risk of acute GvHD, there was a reluctance to use T-cell depletion in the mismatched setting because of increased risk of rejection and relapse. Partial T-cell depletion, by the panning of CDS and CD8 positive T cells may reduce complications related to GvHD without compromising outcomes.


METHODS
In a long-term follow-up of a Phase II study of partial T-cell depletion by panning for BM transplant, 32 recipients received transplants from a single-Ag (HLA A, B, or DR) mismatched family donor; or an HLA serologically-matched unrelated donor. Patients were studied for engraftment, GHD, relapse and survival.


RESULTS
30 (94%) of the patients marrow engrafted. The cumulative risk of Grade 2-4 acute GvHD was 62 - 9%; of Grade 3-4 GvHD, 11 - 6%. The 4-year cumulative risk of relapse was 18 - 8% and actuarial survival was 44 - 9%.


CONCLUSIONS
Partial T-cell depletion had a low rate of severe acute GvHD without compromising engrafment or relapse risk.
Gajewski
J L
JL
Department of Blood and Marrow Transplantation, MD Anderson Cancer Center; Houston, Texas, USA.
Nimer
S
S
Saliba
R M
RM
Thomas
M
M
Przepiorka
D
D
Giralt
S
S
von Besien
K
K
Mehra
R
R
Andersson
B
B
Chan
K W
KW
Ippoliti
C
C
Warkinten
D
D
Feigs
S
S
Territo
M
M
Schiller
G
G
Lebkowski
J
J
Moseley
A M
AM
Lloyd
K
K
von Hoeff
M
M
Okarma
T
T
Champlin
R
R
D000293:Adolescent; D000328:Adult; D001854:Bone Marrow Cells / Q000166:cytology; D016026:Bone Marrow Transplantation / Q000379:methods*; D018956:CD5 Antigens / Q000096:biosynthesis*; D018414:CD8-Positive T-Lymphocytes / Q000378:metabolism*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006086:Graft vs Host Disease / Q000276:immunology / Q000517:prevention & control; D006648:Histocompatibility; D006801:Humans; D007938:Leukemia / Q000628:therapy; D008223:Lymphoma / Q000628:therapy; D008297:Male; D012008:Recurrence; D016896:Treatment Outcome
D018956:CD5 Antigens