Minimizing graft rejection in allogeneic T cell-depleted bone marrow transplantation

J. P. Rigden, Kenneth Cornetta, Edward Srour, M. Hanna, E. R. Broun, R. Hromas, J. Baute, J. Hilton, E. Cox, L. Rubin, R. Gonin, G. Tricot

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Abstract

Between October 1991 and May 1994, 42 patients were treated with cyclophosphamide, thiotepa, and total body irradiation followed by an allogeneic transplantation of marrow depleted of T cells with soybean agglutinin and E-rosetting. Patients included in this study had acute myelogenous leukemia (13), chronic myelogenous leukemia (12), acute lymphocytic leukemia (nine), Hodgkin's disease or non-Hodgkin's lymphoma (four), multiple myeloma (three), or myelodysplastic syndrome (one). The mean age was 34 (range 8 to 51 years). Nineteen patients had a matched sibling donor and 18 received marrow from 6/6 matched unrelated donors while five received transplants from unrelated donors disparate at one DR locus (5/6 match). Time to granulocyte engraftment (AGC ≤ 500/mm3) occurred at a mean of 16.5 days for related and 11.4 days for unrelated transplant recipients, and was related to the increased use of G-CSF in the unrelated population. There was no correlation with number of mononuclear cells, T cells, or CD34-positive cells infused, the rate of engraftment or the incidence of transplant complications. Multivariate analysis determined that G-CSF administration and a diagnosis other than ALL were the only factors associated with a faster rate of engraftment. Patients receiving unrelated donor transplants, those with ALL, or those who had a low T cell number infused (≤ 8.0 x 103 cells/kg) experienced delayed hospital discharge. The regimen resulted in excellent rates of engraftment (95.2%) with only one failure to engraft and one graft rejection. The incidence of grade III-IV acute graft-versus-host disease was 0% with sibling and 26.1% with unrelated donors. There were no cases of veno-occlusive disease. Fifty percent of patients are alive with a mean follow-up of 26.4 months. We conclude that this regimen is well tolerated and results in excellent engraftment with a low incidence of severe graft-versus-host disease and few therapy-related toxicities.

Original languageEnglish
Pages (from-to)913-919
Number of pages7
JournalBone Marrow Transplantation
Volume18
Issue number5
StatePublished - Nov 1996

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Graft Rejection
Unrelated Donors
Bone Marrow Transplantation
T-Lymphocytes
Graft vs Host Disease
Granulocyte Colony-Stimulating Factor
Transplants
Siblings
Incidence
Cell Count
Bone Marrow
Thiotepa
Whole-Body Irradiation
Myelodysplastic Syndromes
Homologous Transplantation
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Multiple Myeloma
Hodgkin Disease
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Granulocytes

Keywords

  • Engraftment
  • Graft rejection
  • T cell depletion

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Rigden, J. P., Cornetta, K., Srour, E., Hanna, M., Broun, E. R., Hromas, R., ... Tricot, G. (1996). Minimizing graft rejection in allogeneic T cell-depleted bone marrow transplantation. Bone Marrow Transplantation, 18(5), 913-919.

Minimizing graft rejection in allogeneic T cell-depleted bone marrow transplantation. / Rigden, J. P.; Cornetta, Kenneth; Srour, Edward; Hanna, M.; Broun, E. R.; Hromas, R.; Baute, J.; Hilton, J.; Cox, E.; Rubin, L.; Gonin, R.; Tricot, G.

In: Bone Marrow Transplantation, Vol. 18, No. 5, 11.1996, p. 913-919.

Research output: Contribution to journalArticle

Rigden, JP, Cornetta, K, Srour, E, Hanna, M, Broun, ER, Hromas, R, Baute, J, Hilton, J, Cox, E, Rubin, L, Gonin, R & Tricot, G 1996, 'Minimizing graft rejection in allogeneic T cell-depleted bone marrow transplantation', Bone Marrow Transplantation, vol. 18, no. 5, pp. 913-919.
Rigden, J. P. ; Cornetta, Kenneth ; Srour, Edward ; Hanna, M. ; Broun, E. R. ; Hromas, R. ; Baute, J. ; Hilton, J. ; Cox, E. ; Rubin, L. ; Gonin, R. ; Tricot, G. / Minimizing graft rejection in allogeneic T cell-depleted bone marrow transplantation. In: Bone Marrow Transplantation. 1996 ; Vol. 18, No. 5. pp. 913-919.
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