title: Effects of T-Cell Depletion on Allogeneic Hematopoietic Stem Cell Transplantation Outcomes in AML Patients.
abstract: Graft versus host disease (GVHD) remains one of the leading causes of morbidity and mortality associated with conventional allogeneic hematopoietic stem cell transplantation (HCT). The use of T-cell depletion significantly reduces this complication. Recent prospective and retrospective data suggest that, in patients with AML in first complete remission, CD34+ selected grafts afford overall and relapse-free survival comparable to those observed in recipients of conventional grafts, while significantly decreasing GVHD. In addition, CD34+ selected grafts allow older patients, and those with medical comorbidities or with only HLA-mismatched donors to successfully undergo transplantation. Prospective data are needed to further define which groups of patients with AML are most likely to benefit from CD34+ selected grafts. Here we review the history of T-cell depletion in AML, and techniques used. We then summarize the contemporary literature using CD34+ selection in recipients of matched or partially mismatched donors (7/8 or 8/8 HLA-matched), and provide a summary of the risks and benefits of using T-cell depletion.
authors.affiliation: Adult Leukemia Service, Massachusetts General Hospital, Boston, MA 02114, USA. ghobbs@partners.org.|Harvard Medical School, Boston, MA 02115, USA. ghobbs@partners.org.
authors.forename: Gabriela Soriano
authors.initials: GS
authors.lastname: Hobbs
authors.affiliation: Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. peralesm@mskcc.org.|Weill Cornell Medical College, New York, NY 10065, USA. peralesm@mskcc.org.
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Perales
keywords: AML; CD34+ selection; T-cell depletion; graft-versus-host disease; hematopoietic stem cell transplantation