PMID- 10845940
OWN - NLM
STAT- MEDLINE
DCOM- 20000810
LR  - 20210216
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 95
IP  - 12
DP  - 2000 Jun 15
TI  - T-cell depletion of bone marrow transplants for leukemia from donors other than 
      HLA-identical siblings: advantage of T-cell antibodies with narrow specificities.
PG  - 3996-4003
AB  - T-cell depletion of donor marrow decreases graft-versus-host disease resulting 
      from transplants from unrelated and human leukocyte antigen (HLA)-mismatched 
      related donors. However, there are diverse strategies for T-cell-depleted 
      transplantation, and it is uncertain whether any improve leukemia-free survival 
      (LFS). To compare strategies for T-cell-depleted alternative donor transplants 
      and to compare T-cell depleted with non-T-cell-depleted transplants, we studied 
      870 patients with leukemia who received T-cell-depleted transplants from 
      unrelated or HLA-mismatched related donors from 1982 to 1994. Outcomes were 
      compared with those of 998 non-T-cell-depleted transplants. We compared LFS using 
      different strategies for T-cell-depleted transplantation considering T-cell 
      depletion technique, intensity of pretransplant conditioning, and posttransplant 
      immune suppression using proportional hazards regression to adjust for other 
      prognostic variables. Five categories of T-cell depletion techniques were 
      considered: narrow-specificity antibodies, broad-specificity antibodies, Campath 
      antibodies, elutriation, and lectins. Strategies resulting in similar LFS were 
      pooled to compare T-cell-depleted with non-T-cell-depleted transplants. 
      Recipients of transplants T-cell depleted by narrow-specificity antibodies had 
      lower treatment failure risk (higher LFS) than recipients of transplants T-cell 
      depleted by other techniques. Compared with non-T-cell-depleted transplants 
      (5-year probability +/- 95% confidence interval [CI] of LFS, 31% +/- 4%), 5-year 
      LFS was 29% +/- 5% (P = NS) after transplants T-cell depleted by 
      narrow-specificity antibodies and 16% +/- 4% (P <.0001) after transplants T-cell 
      depleted by other techniques. After alternative donor transplantation, T-cell 
      depletion of donor marrow by narrow-specificity antibodies resulted in LFS rates 
      that were higher than those for transplants T-cell depleted using other 
      techniques but similar to those for non-T-cell-depleted transplants. (Blood. 
      2000;95:3996-4003)
FAU - Champlin, R E
AU  - Champlin RE
AD  - International Bone Marrow Transplant Registry, Medical College of Wisconsin, 
      Milwaukee, WI 53226, USA.
FAU - Passweg, J R
AU  - Passweg JR
FAU - Zhang, M J
AU  - Zhang MJ
FAU - Rowlings, P A
AU  - Rowlings PA
FAU - Pelz, C J
AU  - Pelz CJ
FAU - Atkinson, K A
AU  - Atkinson KA
FAU - Barrett, A J
AU  - Barrett AJ
FAU - Cahn, J Y
AU  - Cahn JY
FAU - Drobyski, W R
AU  - Drobyski WR
FAU - Gale, R P
AU  - Gale RP
FAU - Goldman, J M
AU  - Goldman JM
FAU - Gratwohl, A
AU  - Gratwohl A
FAU - Gordon-Smith, E C
AU  - Gordon-Smith EC
FAU - Henslee-Downey, P J
AU  - Henslee-Downey PJ
FAU - Herzig, R H
AU  - Herzig RH
FAU - Klein, J P
AU  - Klein JP
FAU - Marmont, A M
AU  - Marmont AM
FAU - O'Reilly, R J
AU  - O'Reilly RJ
FAU - Ringden, O
AU  - Ringden O
FAU - Slavin, S
AU  - Slavin S
FAU - Sobocinski, K A
AU  - Sobocinski KA
FAU - Speck, B
AU  - Speck B
FAU - Weiner, R S
AU  - Weiner RS
FAU - Horowitz, M M
AU  - Horowitz MM
LA  - eng
GR  - P01-CA40053/CA/NCI NIH HHS/United States
GR  - U24-CA76518/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 0 (HLA Antigens)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Isoantibodies)
RN  - 83HN0GTJ6D (Cyclosporine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Antibody Specificity
MH  - Bone Marrow Transplantation/*immunology/mortality
MH  - Child
MH  - Child, Preschool
MH  - Cyclosporine/therapeutic use
MH  - Follow-Up Studies
MH  - Graft vs Host Disease/prevention & control
MH  - HLA Antigens/*immunology
MH  - *Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Infant
MH  - Isoantibodies/immunology
MH  - Leukemia/immunology/mortality/*therapy
MH  - *Lymphocyte Depletion
MH  - Middle Aged
MH  - Nuclear Family
MH  - Registries
MH  - Retrospective Studies
MH  - Survival Rate
MH  - T-Lymphocytes/*immunology
MH  - *Tissue Donors
MH  - Transplantation, Homologous
EDAT- 2000/06/14 09:00
MHDA- 2000/08/12 11:00
CRDT- 2000/06/14 09:00
PHST- 2000/06/14 09:00 [pubmed]
PHST- 2000/08/12 11:00 [medline]
PHST- 2000/06/14 09:00 [entrez]
AID - S0006-4971(20)63977-5 [pii]
PST - ppublish
SO  - Blood. 2000 Jun 15;95(12):3996-4003.