TY - JOUR
T1 - T-cell depletion of bone marrow transplants for leukemia from donors other than HLA-identical siblings
T2 - Advantage of T-cell antibodies with narrow specificities
AU - Champlin, Richard E.
AU - Passweg, Jakob R.
AU - Zhang, Mei Jie
AU - Rowlings, Philip A.
AU - Pelz, Corey J.
AU - Atkinson, Kerry A.
AU - Barrett, A. John
AU - Cahn, Jean Yves
AU - Drobyski, William R.
AU - Gale, Robert Peter
AU - Goldman, John M.
AU - Gratwohl, Alois
AU - Gordon-Smith, Edward C.
AU - Henslee-Downey, P. Jean
AU - Herzig, Roger H.
AU - Klein, John P.
AU - Marmont, Alberto M.
AU - O'Reilly, Richard J.
AU - Ringdén, Olle
AU - Slavin, Shimon
AU - Sobocinski, Kathleen A.
AU - Speck, Bruno
AU - Weiner, Roy S.
AU - Horowitz, Mary M.
PY - 2000/6/15
Y1 - 2000/6/15
N2 - T-cell depletion of donor marrow decreases graff-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 1962 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. (C) 2000 by The American Society of Hematology.
AB - T-cell depletion of donor marrow decreases graff-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 1962 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. (C) 2000 by The American Society of Hematology.
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UR - http://www.scopus.com/inward/citedby.url?scp=18844467941&partnerID=8YFLogxK
M3 - Article
C2 - 10845940
AN - SCOPUS:18844467941
SN - 0006-4971
VL - 95
SP - 3996
EP - 4003
JO - Blood
JF - Blood
IS - 12
ER -