Prophylactic T cell infusion after T cell-depleted bone marrow transplantation in patients with refractory lymphoma
| Autor: | M de Magalhaes-Silverman, Masaki Hayashi, C K Lee, John M. Buatti, R. G. Strauss, Wen Bc, Roger D. Gingrich, Annette J. Schlueter, Raymond J. Hohl |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male medicine.medical_specialty Transplantation Conditioning T cell Graft vs Host Disease Infections Gastroenterology Disease-Free Survival Lymphocyte Depletion immune system diseases Recurrence Internal medicine Cause of Death medicine Humans Transplantation Homologous Cumulative incidence Life Tables Prospective Studies Survival analysis Bone Marrow Transplantation Proportional Hazards Models Transplantation Univariate analysis business.industry Hazard ratio Graft vs Tumor Effect Hematology Pneumonia Middle Aged Survival Analysis Tissue Donors Surgery surgical procedures operative medicine.anatomical_structure Drug Resistance Neoplasm Lymphocyte Transfusion Hemolytic-Uremic Syndrome Female Bone marrow business |
| Zdroj: | Bone marrow transplantation. 29(7) |
| ISSN: | 0268-3369 |
| Popis: | Fifty-two patients with refractory lymphoma were prospectively treated with prophylactic T lymphocyte infusion after T cell-depleted allogeneic bone marrow transplantation, to induce graft-versus-lymphoma effect. Thirty-three patients had related donors; 19 had unrelated donors. After transplantation with marrow that had 0.8 +/- 0.4 x 10(5)CD3(+) cells/kg, T cells up to 1.75 x 10(6) CD3(+) cells/kg were given over 3 months provided > or = grade II acute graft-versus-host disease (GVHD) was not seen. The cumulative incidence of grades II-IV acute GVHD was 69%. Twenty of 32 evaluable patients (63%) developed chronic GVHD. Ten patients (19%) died of GVHD. The Kaplan-Meier 5-year overall survival of all patients was 34%. On multivariate analyses, chronic GVHD was significant for relapse (hazard ratio of 1.7, P < 0.05), and for overall survival (hazard ratio 1.4, P < 0.001). Chemosensitivity was significant for relapse only on univariate analysis. Patients who developed chronic GVHD had 4 years median survival, compared with 9 months in patients without chronic GVHD, P < 0.001. The study shows that patients with chronic GVHD have superior survivals, most probably related to a graft-versus-lymphoma effect, which could be modulated by prophylactic T cell infusion. |
| Databáze: | OpenAIRE |
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