Marrow transplantation from HLA non-identical family donors for the treatment of leukaemia: a pilot study of 15 patients using additional immunosuppression and T-cell depletion.

Abstract

Fifteen patients with high-risk leukaemia were given T-cell depleted marrow transplants from HLA non-identical related donors. They were treated with a combination of total body irradiation (TBI), high-dose cytosine arabinoside (Ara-C) and high-dose melphalan in an attempt to prevent a host-versus-graft reaction. Antilymphocyte globulins were given prior to transplantation for additional immunosuppression to 13 patients and in-vivo monoclonal antibody anti-human LFA1 to two. Engraftment and chimaerism assessed by HLA typing were achieved in 14 patients. Seven developed acute graft-versus-host disease (two fatal), one failed to engraft. Six patients died in complete remission from cytomegalovirus (CMV) interstitial pneumonitis and three remain alive in complete remission 2, 3 and 13 months after transplant. We conclude that aggressive immunosuppression allows for sustained engraftment of T-cell depleted HLA non-identical marrow. The incidence and severity of GVHD are acceptable and CMV pneumonitis remains the major problem.

• Authors: J Y Cahn, P Herve, M Flesch, E Plouvier, E Racadot, J Vuillier, P Montcuquet, A Noir, A Rozenbaum, R Leconte des Floris
• Journal: British journal of haematology (Br J Haematol) Vol. 69 Issue 3 Pg. 345-9 (Jul 1988) ISSN: 0007-1048 [Print] England
• PMID: 3044438 (Publication Type: Journal Article)

Chemical References

• HLA Antigens

Topics

• Adolescent
• Adult
• Bone Marrow Transplantation
• Cell Separation
• Child
• Child, Preschool
• Family
• Female
• HLA Antigens (analysis)
• Humans
• Immunosuppression Therapy
• Leukemia (therapy)
• Male
• Pilot Projects
• T-Lymphocytes
• Tissue Donors