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T Cell Depletion

Excessive T cell depletion of peripheral blood stem cells has an adverse effect upon outcome following allogeneic stem cell transplantation

Bone Marrow Transplantation volume 28, pages 827–834 (2001)Cite this article

Abstract

We evaluated the outcome of two modes of T cell depletion for HLA-identical sibling stem cell transplants in 34 consecutive adult patients: group A (n = 11) received PBSC post CliniMACs immuno-magnetic enrichment of CD34+ cells and group B (n = 23) received bone marrow following in vitro incubation with CAMPATH-1M and complement. All patients received an identical conditioning regimen which consisted of in vivoCAMPATH-1H 20 mg over 5 days, thiotepa 10 mg/kg, cyclophosphamide 120 mg/kg and 14.4 Gy TBI. No additional graft-versus-host disease prophylaxis was given. The mean T cell dose administered was 0.02 ± 0.05 × 106/kg for group A and 2.8 ± 2.8 106/kg for group B (P < 0.001). With a median follow-up of 28 months overall survival was 36.4% for group A at 12 months compared to 78.3% for group B (P = 0.001). Transplant-related mortality in group A at 12 months was 63.6% as compared to 18.0% in group B (P = 0.003). Most of the procedure-related deaths in group A occurred secondary to infection. These results suggest that extensive in vitro T cell depletion of peripheral blood stem cells in combination with in vivo T cell depletion may have profound effects upon the incidence of infections following allogeneic stem cell transplantation and this may adversely effect transplant-related mortality. Bone Marrow Transplantation (2001) 28, 827–834.

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Acknowledgements

We would like to thank Nikki McKaeg, Judith Stuart and Brenda Miller for help in the collection and analysis of data. We would also like to thank Professor Paul Moss and Dr Charlie Craddock for their helpful criticisms regarding the manuscript.

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Authors and Affiliations

  1. Department of Haematology, University College London, London, UK

    R Chakraverty, S Robinson, K Peggs, PD Kottaridis, MJ Watts, SJ Ings, DC Linch, AH Goldstone & S Mackinnon

  2. Sir William Dunn School of Pathology, University of Oxford, UK

    G Hale & H Waldmann

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  1. R Chakraverty
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Chakraverty, R., Robinson, S., Peggs, K. et al. Excessive T cell depletion of peripheral blood stem cells has an adverse effect upon outcome following allogeneic stem cell transplantation. Bone Marrow Transplant 28, 827–834 (2001). https://doi.org/10.1038/sj.bmt.1703248

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