Faculty Collaboration Database

Influence of T-cell depletion on chronic graft-versus-host disease: results of a multicenter randomized trial in unrelated marrow donor transplantation. Blood 2005 Nov 01;106(9):3308-13

Date

07/28/2005

Pubmed ID

16046530

Pubmed Central ID

PMC1895317

DOI

10.1182/blood-2005-04-1614

Scopus ID

2-s2.0-27644515599 (requires institutional sign-in at Scopus site)   89 Citations

Abstract

Donor-derived T cells have been proposed to play a role in pathogenesis of chronic graft-versus-host disease (cGVHD). The impact of ex vivo T-cell depletion (TCD) on cGVHD was analyzed in a randomized multicenter trial involving unrelated donor marrow transplants. A total of 404 patients diagnosed with hematologic malignancies received a total body irradiation-based myeloablative conditioning regimen. GVHD prophylaxis included TCD plus cyclosporine (CSA) or unmodified grafts with CSA plus methotrexate (M/C). Median recipient age was 31.2 years (range, 0.5-55.6 years); median follow-up time since randomization was 4.2 years. The mean number of T cells infused was 1 log lower on the TCD arm. The incidence of cGVHD at 2 years was similar between the TCD and M/C arms, 29% versus 34% (P = .27), respectively. Survival at 3 years from diagnosis of cGVHD was also similar, (TCD 51% versus M/C 58%; P = .29). The proportion of patients with cGVHD who discontinued immunosuppression at 5 years was not different (TCD 72% versus M/C 63%; P = .27), and incidence of serious infections and leukemia relapse were similar on both treatment arms. In spite of a significant reduction of acute GVHD, TCD did not reduce the incidence of cGVHD or improve survival in patients who developed cGVHD.

Author List

Pavletic SZ, Carter SL, Kernan NA, Henslee-Downey J, Mendizabal AM, Papadopoulos E, Gingrich R, Casper J, Yanovich S, Weisdorf D, National Heart, Lung, and Blood Institute Unrelated Donor Marrow Transplantation Trial

MESH terms used to index this publication - Major topics in bold

Acute Disease
Adolescent
Adult
Bone Marrow Transplantation
Child
Child, Preschool
Chronic Disease
Graft vs Host Reaction
Humans
Infant
Middle Aged
Prognosis
Survival Rate
T-Lymphocytes
Transplantation, Homologous