PMID- 14625574
OWN - NLM
STAT- MEDLINE
DCOM- 20040817
LR  - 20181130
IS  - 0268-3369 (Print)
IS  - 0268-3369 (Linking)
VI  - 32
IP  - 11
DP  - 2003 Dec
TI  - Should we T cell deplete sibling grafts for acute myeloid leukaemia in first 
      remission?
PG  - 1039-50
AB  - There is controversy regarding the best approach to the management of patients 
      with acute myeloid leukaemia (AML) in first remission (CR1). The impact of 
      matched related allogeneic transplant in CR1 on the overall survival is 
      equivocal, but what is not in doubt is a significant reduction in the relapse 
      risk, compared to both autologous transplants and intensive chemotherapy, which 
      is because of the allogeneic or the graft-versus-leukaemia (GVL) effect. Yet, 
      this does not always translate to improved survival. T cell depletion (TCD) can 
      reduce deaths related to graft-versus-host disease (GVHD) and its therapy, but 
      might increase the relapse risk. The existing literature suggests that TCD is 
      associated with a disease-free survival (DFS) of 53-80% and is associated with a 
      lower relapse risk than anticipated (0-30%). We discuss the evolution of TCD in 
      allogeneic transplantation and its relevance in AML-CR1 with regard to GVHD, DFS, 
      immune reconstitution and GVL effect. It is possible that by reducing TRM related 
      to GVHD and extramedullary toxicities, particularly in the older patients, TCD 
      might improve the impact of allogeneic transplantation in AML-CR1, provided the 
      immune reconstitution and the relapse risk are not adversely affected. Randomised 
      studies are underway to address these issues.
FAU - Chakrabarti, S
AU  - Chakrabarti S
AD  - Department of Haematology, Queen Elizabeth Hospital, Birmingham, UK.
FAU - Marks, D I
AU  - Marks DI
LA  - eng
PT  - Congress
PL  - England
TA  - Bone Marrow Transplant
JT  - Bone marrow transplantation
JID - 8702459
SB  - IM
EIN - Bone Marrow Transplant. 2004 Feb;33(4):465
MH  - Acute Disease
MH  - Disease-Free Survival
MH  - Graft Survival
MH  - Graft vs Host Disease/mortality/prevention & control
MH  - Graft vs Leukemia Effect
MH  - Hematopoietic Stem Cell Transplantation/adverse effects/*methods/mortality
MH  - Humans
MH  - Leukemia, Myeloid/complications/*therapy
MH  - *Lymphocyte Depletion
MH  - Remission Induction
MH  - Secondary Prevention
MH  - Siblings
MH  - Transplantation, Homologous
EDAT- 2003/11/20 05:00
MHDA- 2004/08/18 05:00
CRDT- 2003/11/20 05:00
PHST- 2003/11/20 05:00 [pubmed]
PHST- 2004/08/18 05:00 [medline]
PHST- 2003/11/20 05:00 [entrez]
AID - 1704281 [pii]
AID - 10.1038/sj.bmt.1704281 [doi]
PST - ppublish
SO  - Bone Marrow Transplant. 2003 Dec;32(11):1039-50. doi: 10.1038/sj.bmt.1704281.