PMID- 21684344
OWN - NLM
STAT- MEDLINE
DCOM- 20120531
LR  - 20211020
IS  - 1523-6536 (Electronic)
IS  - 1083-8791 (Print)
IS  - 1083-8791 (Linking)
VI  - 17
IP  - 12
DP  - 2011 Dec
TI  - Selectively T cell-depleted allografts from HLA-matched sibling donors followed 
      by low-dose posttransplantation immunosuppression to improve transplantation 
      outcome in patients with hematologic malignancies.
PG  - 1855-61
LID - 10.1016/j.bbmt.2011.05.019 [doi]
AB  - We evaluated a photodepletion technique to selectively deplete host-reacting T 
      cells from human leukocyte antigen (HLA)-matched sibling stem cell 
      transplantations with the goal of reducing posttransplantation immunosuppression 
      to improve antimalignancy effects postallografting. Donor lymphocytes were 
      stimulated with irradiated expanded recipient T lymphocytes in an ex vivo mixed 
      lymphocyte reaction. Alloactivated T cells preferentially retaining the 
      photosensitizer 4,5-dibromorhodamine 123 (TH9402) were eliminated by exposure to 
      visible light. Twenty-four patients with hematologic malignancies (16 high risk) 
      conditioned with fludarabine, cyclophosphamide, and totalbody irradiation 
      received a CD34-selected stem cell allograft from an HLA-matched sibling along 
      with 5 x 10(6)/kg selectively depleted donor T cells. Low-dose cyclosporine was 
      used for posttransplantation immunosuppression. Eleven patients survived at a 
      median of 30 months. Probabilities (+/- SEM) for overall and disease-free survival 
      are 39% +/- 12% and 30% +/- 12%, respectively, whereas grade III-IV acute 
      graft-versus-host disease (aGVHD) was 13% +/- 7%. Six patients relapsed, with a 
      relapse probability of 27% +/- 10%. These results suggest that selectively 
      photodepleted allografts in matched sibling transplantations followed by low-dose 
      immunosuppression may protect against severe aGVHD but is associated with delayed 
      immune recovery.
CI  - Published by Elsevier Inc.
FAU - Mielke, Stephan
AU  - Mielke S
AD  - Department of Internal Medicine II, Division of Hematology, University Hospital 
      of Wuerzburg, Wuerzburg, Germany.
FAU - McIver, Zachariah A
AU  - McIver ZA
FAU - Shenoy, Aarthy
AU  - Shenoy A
FAU - Fellowes, Vicki
AU  - Fellowes V
FAU - Khuu, Hahn
AU  - Khuu H
FAU - Stroncek, David F
AU  - Stroncek DF
FAU - Leitman, Susan F
AU  - Leitman SF
FAU - Childs, Richard
AU  - Childs R
FAU - Battiwalla, Minoo
AU  - Battiwalla M
FAU - Koklanaris, Eleftheria
AU  - Koklanaris E
FAU - Haggerty, Janice
AU  - Haggerty J
FAU - Savani, Bipin N
AU  - Savani BN
FAU - Rezvani, Katie
AU  - Rezvani K
FAU - Barrett, A John
AU  - Barrett AJ
LA  - eng
GR  - Z99 HL999999/Intramural NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20110531
PL  - United States
TA  - Biol Blood Marrow Transplant
JT  - Biology of blood and marrow transplantation : journal of the American Society for 
      Blood and Marrow Transplantation
JID - 9600628
RN  - 0 (HLA Antigens)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Disease-Free Survival
MH  - Female
MH  - Graft vs Host Disease/etiology/immunology/prevention & control
MH  - HLA Antigens/*immunology
MH  - Hematologic Neoplasms/immunology/pathology/*surgery
MH  - Humans
MH  - Lymphocyte Depletion/*methods
MH  - Male
MH  - Middle Aged
MH  - Peripheral Blood Stem Cell Transplantation/*methods
MH  - Siblings
MH  - T-Lymphocytes/*immunology
MH  - Tissue Donors
MH  - Transplantation, Homologous
MH  - Young Adult
PMC - PMC3179818
MID - NIHMS300560
EDAT- 2011/06/21 06:00
MHDA- 2012/06/01 06:00
PMCR- 2012/12/01
CRDT- 2011/06/21 06:00
PHST- 2011/03/15 00:00 [received]
PHST- 2011/05/12 00:00 [accepted]
PHST- 2011/06/21 06:00 [entrez]
PHST- 2011/06/21 06:00 [pubmed]
PHST- 2012/06/01 06:00 [medline]
PHST- 2012/12/01 00:00 [pmc-release]
AID - S1083-8791(11)00238-2 [pii]
AID - 10.1016/j.bbmt.2011.05.019 [doi]
PST - ppublish
SO  - Biol Blood Marrow Transplant. 2011 Dec;17(12):1855-61. doi: 
      10.1016/j.bbmt.2011.05.019. Epub 2011 May 31.