A COMPARATIVE STUDY OF T-CELL DEPLETED AND NON-DEPLETED MARROW TRANSPLANTATION FOR HEMATOLOGICAL MALIGNANCY |
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| Authors: | K. ATKINSON J. BIGGS M. COOLEY H. FARRELLY E. O'FLAHERTY H. RAPHAEL M. ASHBY A. CONCANNON A. DODDS G. MORGAN I. F. C. McKENZIE |
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| Affiliation: | Physician to the Bone Marrow Transplant Unit and NH&MRC Senior Research Fellow, St Vincent's Hospital, NSW;Assoc. Professor of Medicine, Director, Department of Haematology. St Vincent's Hospital, NSW;Senior Research Officer, Department of Haematology, St Vincent's Hospital, NSW;Research Officer, Department of Haematology, St Vincent's Hospital, NSW;Research Officer, Department of Haematology, St Vincent's Hospital, NSW;Data Analyst, Department of Haematology, St Vincent's Hospital, NSW;Data Collector, Department of Haematology, St Vincent's Hospital, NSW;Staff Haematologist, Department of Haematology, St Vincent's Hospital, NSW;Staff Haematologist, Department of Haematology, St Vincent's Hospital, NSW;Staff Radiation Oncologist, St Vincent's Hospital, NSW;Professor of Pathology and Director, Research Centre for Cancer and Transplantation, University of Melbourne, VIC |
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| Abstract: | ![]()
Sixteen patients with hematological malignancy received cyclophosphamide (120 mg/kg), fractionated total body irradiation (12 Gy), oral cyclosporin, and an HLA-identical sibling marrow transplant depleted of T cells by incubation with the monoclonal antibody anti-HuLy-m1 (CD2) and rabbit complement with (five patients) or without (11 patients) anti-HuLy-m8 (CD8). These 16 patients were compared historically to 84 patients with hematological malignancy receiving cyclophosphamide (120 mg/kg), fractionated total body irradiation (12 or 14 Gy), oral cyclosporin, and unmanipulated HLA-identical sibling marrow, for parameters of engraftment and graft-versus-host disease (GVHD). Graft failure occurred in one of the 16 T-cell depleted recipients and in one of the 84 non-depleted recipients. Engraftment was slightly but significantly slower in the T-cell depleted group and bacterial infections significantly more, frequent and severe than in the unmanipulated group. There was a suggestion that the severity of acute GVHD was reduced in those receiving T depleted marrow. Randomized trials will be necessary to determine if marrow T-cell depletion results in superior long-term leukemia-free survival. |
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| Keywords: | T-cell depletion marrow transplant hematological malignancy |
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