Impact of T-cell depletion on outcome of allogeneic bone-marrow transplantation for standard-risk leukaemias

Lancet. 1987 Jul 25;2(8552):175-8. doi: 10.1016/s0140-6736(87)90763-x.

Abstract

71 leukaemic patients having HLA-matched bone-marrow transplants (BMT) were randomised to receive whole marrow (group A) or marrow depleted of T cells by treatment with monoclonal antibodies (anti CD4-CD5-CD8, group B; anti CD2-CD5-CD7, group C) plus complement. All patients received cyclophosphamide and total body irradiation before transplantation and cyclosporin after BMT. Marrow treatment removed 97% of T cells (median) in group B and 99% in group C. Although both serious and mild graft-versus-host disease (GVHD) were reduced in T-cell depleted patients, graft failure and relapse were increased. Graft failure was caused by GVHD and transplant complications in the controls and by rejection and relapse in the T-cell depleted groups; relapse-free survival did not differ between the groups. Without better control of host immunity and of the residual leukaemia T-cell depletion of the marrow, BMT should not be pursued in standard-risk patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antibodies, Monoclonal / therapeutic use
  • Bone Marrow Transplantation*
  • Clinical Trials as Topic
  • Complement System Proteins / immunology
  • Cyclosporins / therapeutic use
  • Female
  • Follow-Up Studies
  • Graft vs Host Disease / prevention & control
  • Humans
  • In Vitro Techniques
  • Leukemia / therapy*
  • Male
  • Prospective Studies
  • Random Allocation
  • Remission Induction
  • Risk
  • T-Lymphocytes* / immunology

Substances

  • Antibodies, Monoclonal
  • Cyclosporins
  • Complement System Proteins