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Post-Transplant Events

Donor CD4 T cells convert mixed to full donor T-cell chimerism and replenish the CD52-positive T-cell pool after alemtuzumab-based T-cell-depleted allo-transplantation

Bone Marrow Transplantation volume 45, pages 668–674 (2010)Cite this article

Abstract

Donor lymphocyte infusions (DLI) are used to resolve mixed T-cell chimerism (TCC) after allo-SCT despite a substantial risk of GVHD. We analyzed the impact of prophylactic CD8-depleted (CD8depl) DLI in 20 recipients of anti-CD52 alemtuzumab in vivo T-cell-depleted allografts with declining donor TCC after day +60. A total of 13 patients received CD8depl DLI and 7 patients did not. All but one of the DLI patients converted to complete donor T-cell chimeras, whereas only one non-DLI patient converted spontaneously. DLI induced transient acute GVHD in five and extensive chronic GVHD in two patients. These data suggest the use of CD8depl DLI as an effective treatment for mixed TCC, particularly in patients at high risk for GVHD. We also observed that the majority of reconstituting donor-derived T cells after alemtuzumab conditioning were CD52-negative. CD8depl DLI significantly increased the proportion of CD52-positive CD4 T cells, whereby their beneficial effect on reconstituting the post-transplant T-cell repertoire was shown.

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Acknowledgements

This work was supported by grant DJCLS 07/07 of the Deutsche José Carreras-Leukämiestiftung e. V. and an unrestricted grant by the Bayer Vital GmbH, Germany. We further disclose no primary financial relationship with a company that has a direct financial interest in the subject matter or products discussed in the submitted manuscript, or with a company that produces a competing product. We thankfully acknowledge the technical assistance of Diana Wolff and the data-management by Christiane Schön, Uschi Gerhards, Birgit Waldeck and Sina Wenzel.

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Authors and Affiliations

  1. Department of Medicine 3, Hematology and Oncology, Johannes Gutenberg-University, Mainz, Germany

    R G Meyer, E M Wagner, A Konur, T Schmitt, J Hemmerling, D Wehler, U F Hartwig, C Huber, K Kolbe & W Herr

  2. Department of Legal Medicine, Johannes Gutenberg-University, Mainz, Germany

    K Bender

  3. Division of Hematology, Department of Internal Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland

    E Roosnek

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  1. R G Meyer
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Correspondence to R G Meyer.

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Meyer, R., Wagner, E., Konur, A. et al. Donor CD4 T cells convert mixed to full donor T-cell chimerism and replenish the CD52-positive T-cell pool after alemtuzumab-based T-cell-depleted allo-transplantation. Bone Marrow Transplant 45, 668–674 (2010). https://doi.org/10.1038/bmt.2009.212

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