T cell-depleted unrelated donor stem cell transplantation provides favorable disease-free survival for adults with hematologic malignancies Journal Article


Authors: Jakubowski, A. A.; Small, T. N.; Kernan, N. A.; Castro-Malaspina, H.; Collins, N.; Koehne, G.; Hsu, K. C.; Perales, M. A.; Papanicolaou, G.; van den Brink, M. R. M.; O'Reilly, R. J.; Young, J. W.; Papadopoulos, E. B.
Article Title: T cell-depleted unrelated donor stem cell transplantation provides favorable disease-free survival for adults with hematologic malignancies
Abstract: We report a prospective phase 11 clinical trial in 35 adult patients (median age 40.5 years) with hematologic malignancies who received T cell depleted, hematopoietic stem cell transplants from HLA-compatible, unrelated donors. The cytoreductive regimen consisted of hyperfractionated total-body irradiation, thiotepa, and fludarabine. The preferred graft source was granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood stem cells (PBSC). PBSC were CD34(+) selected, followed by sheep erythrocyte rosetting to deplete residual T cells. Anti-thymocyte globulin provided graft rejection prophylaxis. No additional graft-versus-host disease (GVHD) prophylaxis was planned. Estimated disease-free survival at 4 years is 56.8% for the entire group and 75% in patients with standard-risk disease. The cumulative incidence of relapse is 6%. Acute GVHD grade II-III developed in 9% and chronic GVHD in 29% of patients. Fatal infections occurred in 5 of 35 (14%) patients. There was 1 late graft failure. This study demonstrates durable engraftment with a low overall incidence of GVHD. Its curative potential is reflected in the remarkably low relapse rate at 4 years. Bid Blood Marrow Transplant 17: 1335-1342 (2011) (C) 2011 American Society for Blood and Marrow Transplantation
Keywords: leukemia; graft failure; hematologic malignancies; t cell depletion; versus-host-disease; bone-marrow-transplantation; acute myeloid-leukemia; chronic myelogenous; unrelated donor; hematopoietic stem cell transplant; ii-iii trial; antithymocyte globulin; lymphocyte infusion; leukocyte infusions; immune recovery
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 17
Issue: 9
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2011-09-01
Start Page: 1335
End Page: 1342
Language: English
DOI: 10.1016/j.bbmt.2011.01.005
ACCESSION: WOS:000294594900009
PROVIDER: wos
PMCID: PMC3094599
PUBMED: 21232623
Notes: --- - Article - "Source: Wos"
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MSK Authors
  1. Nancy Kernan
    445 Kernan
  2. Trudy Small
    220 Small
  3. Miguel-Angel Perales
    494 Perales
  4. Katharine C Hsu
    152 Hsu
  5. Guenther Koehne
    192 Koehne
  6. James W Young
    285 Young
  7. Richard O'Reilly
    603 O'Reilly
  8. Nancy Collins
    72 Collins