Matched unrelated donor bone marrow transplantation for chronic myeloid leukaemia in chronic phase: comparison of ex vivo and in vivo T-cell depletion

Bone Marrow Transplant. 1993:11 Suppl 1:107-11.

Abstract

Between January 1985 and March 1992, 48 patients with chronic phase CML underwent BMT from volunteer unrelated donors (MUD) serologically identical at HLA-A, B and DR loci. 19 patients received donor marrow ex vivo T-cell depleted (EX-TCD) with Campath monoclonal antibodies. 29 patients received unmanipulated donor marrow with CsA/MTX GVHD prophylaxis; 28 received additional intravenous antilymphocyte therapy from day +1 to +5 (IN-TCD). Overall 26 patients survive at median follow up of 362 days; actuarial survival at 3 years is 50%. 3 patients have sustained haematological relapse; actuarial leukaemia-free survival is 38%. There is no difference in overall survival between the EX-TCD and IN-TCD groups, but primary graft failure (n = 4) occurred only in the EX-TCD group, while GVHD (grade II or greater) occurred more frequently in the IN-TCD group (61% vs. 29%, p = 0.084). The optimum method for GVHD prophylaxis in MUD BMT remains uncertain.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation / immunology*
  • Child
  • DNA / genetics
  • Female
  • HLA-A Antigens / genetics
  • HLA-A Antigens / immunology
  • HLA-B Antigens / genetics
  • HLA-B Antigens / immunology
  • HLA-DR Antigens / genetics
  • HLA-DR Antigens / immunology
  • Humans
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / epidemiology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / immunology*
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery*
  • Lymphocyte Depletion*
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Retrospective Studies
  • T-Lymphocytes / immunology
  • Tissue Donors
  • Transplantation, Homologous
  • United Kingdom / epidemiology

Substances

  • HLA-A Antigens
  • HLA-B Antigens
  • HLA-DR Antigens
  • DNA