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Low-dose donor CD8+ cells in the CD4-depleted graft prevent allogeneic marrow graft rejection and severe graft-versus-host disease for chronic myeloid leukemia patients in first chronic phase.
Bone Marrow Transplant. 1997 Dec; 20(11):945-52.BM

Abstract

Based on previous experiences in animals and humans, low doses of CD8+ lymphocytes infused together with the marrow graft seem to enhance engraftment after allogeneic T cell-depleted marrow transplantation. From April 1994 to February 1997, 12 patients with chronic myelogenous leukemia in first chronic phase receiving a bone marrow transplant (BMT) from an HLA-identical sibling were included in a pilot study of T cell subset depletion. Total depletion of CD4+ cells of the marrow graft and partial depletion of CD8+ cells was performed by immunomagnetic separation. In order to improve the engraftment rate, we infused a low fixed number of CD8+ lymphocytes (0.25 x 10(6)/kg). All the patients were at high risk of developing acute graft-versus-host disease (GVHD), with a recipient age of >30 years, and/or donor sensitized by previous pregnancies or transfusions. All of them received cyclosporin A and methotrexate post-BMT. No graft failure was observed. The grade III-IV GVHD rate was 16.6%, and the actuarial survival at 3 years is 81.8%. Immunological recovery showed persistent CD8+ HLA-DR+ lymphocytosis 8 months after transplant. Relapses were not observed. This experience shows the importance of CD8+ cells to ensure correct engraftment, decreasing the GVHD rate.

Authors+Show Affiliations

Department of Clinical Hematology, Hospital Duran i Reynals, Institut Català d'Oncologia, Barcelona, Spain.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 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

9422473

Citation

Gallardo, D, et al. "Low-dose Donor CD8+ Cells in the CD4-depleted Graft Prevent Allogeneic Marrow Graft Rejection and Severe Graft-versus-host Disease for Chronic Myeloid Leukemia Patients in First Chronic Phase." Bone Marrow Transplantation, vol. 20, no. 11, 1997, pp. 945-52.
Gallardo D, García-López J, Sureda A, et al. Low-dose donor CD8+ cells in the CD4-depleted graft prevent allogeneic marrow graft rejection and severe graft-versus-host disease for chronic myeloid leukemia patients in first chronic phase. Bone Marrow Transplant. 1997;20(11):945-52.
Gallardo, D., García-López, J., Sureda, A., Canals, C., Ferra, C., Cancelas, J. A., Berlanga, J. J., Brunet, S., Boqué, C., Picón, M., Torrico, C., Amill, B., Martino, R., Martínez, C., Martín-Henao, G., Domingo-Albós, A., & Grañena, A. (1997). Low-dose donor CD8+ cells in the CD4-depleted graft prevent allogeneic marrow graft rejection and severe graft-versus-host disease for chronic myeloid leukemia patients in first chronic phase. Bone Marrow Transplantation, 20(11), 945-52.
Gallardo D, et al. Low-dose Donor CD8+ Cells in the CD4-depleted Graft Prevent Allogeneic Marrow Graft Rejection and Severe Graft-versus-host Disease for Chronic Myeloid Leukemia Patients in First Chronic Phase. Bone Marrow Transplant. 1997;20(11):945-52. PubMed PMID: 9422473.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-dose donor CD8+ cells in the CD4-depleted graft prevent allogeneic marrow graft rejection and severe graft-versus-host disease for chronic myeloid leukemia patients in first chronic phase. AU - Gallardo,D, AU - García-López,J, AU - Sureda,A, AU - Canals,C, AU - Ferra,C, AU - Cancelas,J A, AU - Berlanga,J J, AU - Brunet,S, AU - Boqué,C, AU - Picón,M, AU - Torrico,C, AU - Amill,B, AU - Martino,R, AU - Martínez,C, AU - Martín-Henao,G, AU - Domingo-Albós,A, AU - Grañena,A, PY - 1998/1/9/pubmed PY - 1998/1/9/medline PY - 1998/1/9/entrez SP - 945 EP - 52 JF - Bone marrow transplantation JO - Bone Marrow Transplant VL - 20 IS - 11 N2 - Based on previous experiences in animals and humans, low doses of CD8+ lymphocytes infused together with the marrow graft seem to enhance engraftment after allogeneic T cell-depleted marrow transplantation. From April 1994 to February 1997, 12 patients with chronic myelogenous leukemia in first chronic phase receiving a bone marrow transplant (BMT) from an HLA-identical sibling were included in a pilot study of T cell subset depletion. Total depletion of CD4+ cells of the marrow graft and partial depletion of CD8+ cells was performed by immunomagnetic separation. In order to improve the engraftment rate, we infused a low fixed number of CD8+ lymphocytes (0.25 x 10(6)/kg). All the patients were at high risk of developing acute graft-versus-host disease (GVHD), with a recipient age of >30 years, and/or donor sensitized by previous pregnancies or transfusions. All of them received cyclosporin A and methotrexate post-BMT. No graft failure was observed. The grade III-IV GVHD rate was 16.6%, and the actuarial survival at 3 years is 81.8%. Immunological recovery showed persistent CD8+ HLA-DR+ lymphocytosis 8 months after transplant. Relapses were not observed. This experience shows the importance of CD8+ cells to ensure correct engraftment, decreasing the GVHD rate. SN - 0268-3369 UR - https://www.unboundmedicine.com/medline/citation/9422473/Low_dose_donor_CD8+_cells_in_the_CD4_depleted_graft_prevent_allogeneic_marrow_graft_rejection_and_severe_graft_versus_host_disease_for_chronic_myeloid_leukemia_patients_in_first_chronic_phase_ L2 - https://doi.org/10.1038/sj.bmt.1701008 DB - PRIME DP - Unbound Medicine ER -