Influence of T-cell depletion on chronic graft-versus-host disease: Results of a multicenter randomized trial in unrelated marrow donor transplantation Journal Article


Authors: Pavletic, S. Z.; Carter, S. L.; Kernan, N. A.; Henslee-Downey, J.; Mendizabal, A. M.; Papadopoulos, E.; Gingrich, R.; Casper, J.; Yanovich, S.; Weisdorf, D.
Article Title: Influence of T-cell depletion on chronic graft-versus-host disease: Results of a multicenter randomized trial in unrelated marrow donor transplantation
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.
Keywords: survival; leukemia; methotrexate; prophylaxis; cyclosporine; association; term follow-up; bone-marrow; cd34; identical sibling transplantation
Journal Title: Blood
Volume: 106
Issue: 9
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2005-11-01
Start Page: 3308
End Page: 3313
Language: English
DOI: 10.1182/blood-2005-04-1614
ACCESSION: WOS:000232917400063
PROVIDER: wos
PMCID: PMC1895317
PUBMED: 16046530
Notes: --- - Article - "Source: Wos"
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  1. Nancy Kernan
    477 Kernan