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.
journal_name
Bloodjournal_title
Bloodauthors
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.doi
10.1182/blood-2005-04-1614subject
Has Abstractpub_date
2005-11-01 00:00:00pages
3308-13issue
9eissn
0006-4971issn
1528-0020pii
2005-04-1614journal_volume
106pub_type
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