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CD8+ T-cell-depleted, matched unrelated donor, allogeneic bone marrow transplantation for advanced AML using busulfan-based preparative regimens.
Bone Marrow Transplant. 2005 Feb; 35(3):247-52.BM

Abstract

The role of T-cell depletion (TCD) to prevent graft-versus-host disease (GVHD) after matched unrelated donor allogeneic bone marrow transplant (MUD BMT) remains undefined. Most studies employ total body irradiation and pan TCD. Between March 1993 and June 2002, we treated 33 relapsed acute myelogenous leukemia (AML) patients with busulfan-based preparative regimens and selective TCD. The preparative regimen consisted of busulfan 14 mg/kg, cyclophosphamide 120 mg/kg and VP-16 50 mg/kg in all but one patient who only received busulfan and cyclophosphamide. Donor marrow was depleted of CD8+ T cells by immunomagnetic bead separation. The patients were also treated with cyclosporine and methylprednisolone or FK-506 and mini-dose methotrexate. Four (15%) of 33 patients developed graft failure or rejection. However, three of these patients were serologically mismatched at HLA-Cw. Although 67% of evaluable patients developed acute GVHD, severe grade III-IV acute GVHD only developed in 19%. The severity of acute GVHD correlated with the degree of CD8+ TCD. Median relapse-free survival was 5 months among 20 patients treated with active AML, and 28 months among 13 patients treated in complete remission. Our results confirm that MUD BMT with CD8+ TCD for AML is a potentially curative treatment option.

Authors+Show Affiliations

Department of Hematology and Medical Oncology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. kalaycm@ccf.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15580282

Citation

Kalaycio, M, et al. "CD8+ T-cell-depleted, Matched Unrelated Donor, Allogeneic Bone Marrow Transplantation for Advanced AML Using Busulfan-based Preparative Regimens." Bone Marrow Transplantation, vol. 35, no. 3, 2005, pp. 247-52.
Kalaycio M, Rybicki L, Pohlman B, et al. CD8+ T-cell-depleted, matched unrelated donor, allogeneic bone marrow transplantation for advanced AML using busulfan-based preparative regimens. Bone Marrow Transplant. 2005;35(3):247-52.
Kalaycio, M., Rybicki, L., Pohlman, B., Sobecks, R., Ball, E., Cook, D., Andresen, S., Kuczkowski, E., & Bolwell, B. (2005). CD8+ T-cell-depleted, matched unrelated donor, allogeneic bone marrow transplantation for advanced AML using busulfan-based preparative regimens. Bone Marrow Transplantation, 35(3), 247-52.
Kalaycio M, et al. CD8+ T-cell-depleted, Matched Unrelated Donor, Allogeneic Bone Marrow Transplantation for Advanced AML Using Busulfan-based Preparative Regimens. Bone Marrow Transplant. 2005;35(3):247-52. PubMed PMID: 15580282.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - CD8+ T-cell-depleted, matched unrelated donor, allogeneic bone marrow transplantation for advanced AML using busulfan-based preparative regimens. AU - Kalaycio,M, AU - Rybicki,L, AU - Pohlman,B, AU - Sobecks,R, AU - Ball,E, AU - Cook,D, AU - Andresen,S, AU - Kuczkowski,E, AU - Bolwell,B, PY - 2004/12/8/pubmed PY - 2005/7/8/medline PY - 2004/12/8/entrez SP - 247 EP - 52 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 35 IS - 3 N2 - The role of T-cell depletion (TCD) to prevent graft-versus-host disease (GVHD) after matched unrelated donor allogeneic bone marrow transplant (MUD BMT) remains undefined. Most studies employ total body irradiation and pan TCD. Between March 1993 and June 2002, we treated 33 relapsed acute myelogenous leukemia (AML) patients with busulfan-based preparative regimens and selective TCD. The preparative regimen consisted of busulfan 14 mg/kg, cyclophosphamide 120 mg/kg and VP-16 50 mg/kg in all but one patient who only received busulfan and cyclophosphamide. Donor marrow was depleted of CD8+ T cells by immunomagnetic bead separation. The patients were also treated with cyclosporine and methylprednisolone or FK-506 and mini-dose methotrexate. Four (15%) of 33 patients developed graft failure or rejection. However, three of these patients were serologically mismatched at HLA-Cw. Although 67% of evaluable patients developed acute GVHD, severe grade III-IV acute GVHD only developed in 19%. The severity of acute GVHD correlated with the degree of CD8+ TCD. Median relapse-free survival was 5 months among 20 patients treated with active AML, and 28 months among 13 patients treated in complete remission. Our results confirm that MUD BMT with CD8+ TCD for AML is a potentially curative treatment option. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/15580282/CD8+_T_cell_depleted_matched_unrelated_donor_allogeneic_bone_marrow_transplantation_for_advanced_AML_using_busulfan_based_preparative_regimens_ L2 - https://doi.org/10.1038/sj.bmt.1704736 DB - PRIME DP - Unbound Medicine ER -