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T-cell depleted peripheral blood stem cell allotransplantation with T-cell add-back for patients with hematological malignancies: effect of chronic GVHD on outcome.
Biol Blood Marrow Transplant. 2006 Dec; 12(12):1318-25.BB

Abstract

One hundred thirty-eight patients with hematologic malignancies received myeloablative T cell-depleted peripheral blood stem cell transplant (PBSCT) from an HLA-identical sibling donor. The T cell dose was adjusted to 0.2-1 x 10(5) CD3(+) cells/kg. The CD34 dose was 2.7-16 x 10(6)/kg. Patients with acute graft-versus-host disease (GVHD) grade <2 received 1 or 2 donor lymphocyte infusions of 10(7) CD3(+) cells/kg between days 45 and 100. Patients were designated according to relapse probability as standard or high relapse risk (77 and 61, respectively). Overall survival (OS), relapse-free survival, relapse, and transplant-related mortality (TRM) were 58%, 46%, 40%, and 20%, respectively, after a median follow-up of 4 years. Fifty-three (39%) and 21 (15%) patients developed grade 2-4 and 3-4 acute GVHD. Forty-two (36%) had limited and 29 (25%) had extensive chronic GVHD. In multivariate analysis, disease risk was an independent factor for OS and relapse, day-30 lymphocyte count for OS and TRM, and chronic GVHD for OS and relapse. PBSCT with early T cell add back leads to comparable rates of chronic GVHD compared with T cell-replete PBSCT. However, this chronic GVHD after T cell add back is associated with less mortality and retains a protective effect in terms of relapse, at least in the standard-risk patients.

Authors+Show Affiliations

Stem Cell Allotransplantation Section, Hematology Branch, National Heart, Lung and Blood Institute, Bethesda, Maryland 20892-1202, USA.No affiliation info availableNo 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)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17162214

Citation

Montero, Aldemar, et al. "T-cell Depleted Peripheral Blood Stem Cell Allotransplantation With T-cell Add-back for Patients With Hematological Malignancies: Effect of Chronic GVHD On Outcome." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 12, no. 12, 2006, pp. 1318-25.
Montero A, Savani BN, Shenoy A, et al. T-cell depleted peripheral blood stem cell allotransplantation with T-cell add-back for patients with hematological malignancies: effect of chronic GVHD on outcome. Biol Blood Marrow Transplant. 2006;12(12):1318-25.
Montero, A., Savani, B. N., Shenoy, A., Read, E. J., Carter, C. S., Leitman, S. F., Mielke, S., Rezvani, K., Childs, R., & Barrett, A. J. (2006). T-cell depleted peripheral blood stem cell allotransplantation with T-cell add-back for patients with hematological malignancies: effect of chronic GVHD on outcome. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 12(12), 1318-25.
Montero A, et al. T-cell Depleted Peripheral Blood Stem Cell Allotransplantation With T-cell Add-back for Patients With Hematological Malignancies: Effect of Chronic GVHD On Outcome. Biol Blood Marrow Transplant. 2006;12(12):1318-25. PubMed PMID: 17162214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - T-cell depleted peripheral blood stem cell allotransplantation with T-cell add-back for patients with hematological malignancies: effect of chronic GVHD on outcome. AU - Montero,Aldemar, AU - Savani,Bipin N, AU - Shenoy,Aarthi, AU - Read,Elizabeth J, AU - Carter,Charles S, AU - Leitman,Susan F, AU - Mielke,Stephan, AU - Rezvani,Katayoun, AU - Childs,Richard, AU - Barrett,A John, PY - 2006/05/30/received PY - 2006/08/14/accepted PY - 2006/12/13/pubmed PY - 2007/3/16/medline PY - 2006/12/13/entrez SP - 1318 EP - 25 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. VL - 12 IS - 12 N2 - One hundred thirty-eight patients with hematologic malignancies received myeloablative T cell-depleted peripheral blood stem cell transplant (PBSCT) from an HLA-identical sibling donor. The T cell dose was adjusted to 0.2-1 x 10(5) CD3(+) cells/kg. The CD34 dose was 2.7-16 x 10(6)/kg. Patients with acute graft-versus-host disease (GVHD) grade <2 received 1 or 2 donor lymphocyte infusions of 10(7) CD3(+) cells/kg between days 45 and 100. Patients were designated according to relapse probability as standard or high relapse risk (77 and 61, respectively). Overall survival (OS), relapse-free survival, relapse, and transplant-related mortality (TRM) were 58%, 46%, 40%, and 20%, respectively, after a median follow-up of 4 years. Fifty-three (39%) and 21 (15%) patients developed grade 2-4 and 3-4 acute GVHD. Forty-two (36%) had limited and 29 (25%) had extensive chronic GVHD. In multivariate analysis, disease risk was an independent factor for OS and relapse, day-30 lymphocyte count for OS and TRM, and chronic GVHD for OS and relapse. PBSCT with early T cell add back leads to comparable rates of chronic GVHD compared with T cell-replete PBSCT. However, this chronic GVHD after T cell add back is associated with less mortality and retains a protective effect in terms of relapse, at least in the standard-risk patients. SN - 1083-8791 UR - https://www.unboundmedicine.com/medline/citation/17162214/T_cell_depleted_peripheral_blood_stem_cell_allotransplantation_with_T_cell_add_back_for_patients_with_hematological_malignancies:_effect_of_chronic_GVHD_on_outcome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(06)00577-5 DB - PRIME DP - Unbound Medicine ER -