Excessive T cell depletion of peripheral blood stem cells has an adverse effect upon outcome following allogeneic stem cell transplantation.

Journal article

We evaluated the outcome of two modes of T cell depletion for HLA-identical sibling stem cell transplants in 34 consecutive adult patients: group A (n = 11) received PBSC post CliniMACs immuno-magnetic enrichment of CD34(+) cells and group B (n = 23) received bone marrow following in vitro incubation with CAMPATH-1M and complement. All patients received an identical conditioning regimen which consisted of in vivoCAMPATH-1H 20 mg over 5 days, thiotepa 10 mg/kg, cyclophosphamide 120 mg/kg and 14.4 Gy TBI. No additional graft-versus-host disease prophylaxis was given. The mean T cell dose administered was 0.02 +/- 0.05 x 10(6)/kg for group A and 2.8 +/- 2.8 10(6)/kg for group B (P < 0.001). With a median follow-up of 28 months overall survival was 36.4% for group A at 12 months compared to 78.3% for group B (P = 0.001). Transplant-related mortality in group A at 12 months was 63.6% as compared to 18.0% in group B (P = 0.003). Most of the procedure-related deaths in group A occurred secondary to infection. These results suggest that extensive in vitro T cell depletion of peripheral blood stem cells in combination with in vivo T cell depletion may have profound effects upon the incidence of infections following allogeneic stem cell transplantation and this may adversely effect transplant-related mortality.

Authors: Chakraverty, R; Robinson, S; Peggs, K; Kottaridis, P; Watts, M

• Publication status: Published
• Journal: Bone marrow transplantation
• Volume: 28
• Issue: 9
• Pages: 827-834
• Publication date: 2001-11-01
• DOI: 10.1038/sj.bmt.1703248
• EISSN: 1476-5365
• ISSN: 0268-3369
• Language: English
• Keywords: Myelodysplastic Syndromes; Lymphocyte Depletion; Antibodies, Monoclonal; Treatment Outcome; Retrospective Studies; Humans; T-Lymphocytes; Survival Rate; Antibodies, Monoclonal, Humanized; Survival Analysis; Transplantation, Homologous; Immunomagnetic Separation; Remission Induction; Antibodies, Neoplasm; Hematopoietic Stem Cell Transplantation; Graft vs Host Disease; Follow-Up Studies; Life Tables; Middle Aged; Female; Adult; Infection; Male; Hematologic Neoplasms; Incidence