The impact of partial T cell depletion on overall transplant-related toxicity, graft function and survival after HLA-identical allogeneic bone marrow transplantation in standard risk adult patients with leukemia
In this single-center study, a consecutive cohort of 59 adult patients transplanted with HLA-identical bone marrow and receiving graft-versus-host disease (GVHD) prophylaxis with either standard cyclosporine/methotrexate (n = 33) or partial T cell depletion (E-rosetting) (TCD, n = 26 were analyzed)....
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| Veröffentlicht in: | Bone marrow transplantation (Basingstoke) 2001-11, Vol.28 (10), p.917-922 |
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| container_title | Bone marrow transplantation (Basingstoke) |
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| creator | SCHOTS, R VAN RIET, I BEN OTHMAN, T TRULLEMANS, F DE WAELE, M VAN CAMP, B |
| description | In this single-center study, a consecutive cohort of 59 adult patients transplanted with HLA-identical bone marrow and receiving graft-versus-host disease (GVHD) prophylaxis with either standard cyclosporine/methotrexate (n = 33) or partial T cell depletion (E-rosetting) (TCD, n = 26 were analyzed). Only patients with chronic myeloid leukemia in first chronic phase or acute leukemia/myelodysplasia in first or second remission were included. Except for age (median 28 vs 42 years), both groups were comparable in terms of diagnosis, conditioning regimen and growth factor support. TCD significantly reduced >grade II acute GVHD (0 vs 24%, P = 0.02), chronic GVHD (8.5 vs 45%, P = 0.007) and other major bone marrow transplant (BMT)-related complications (4 vs 36%, P = 0.005). TCD decreased overall transplant-related mortality (11.5 vs 36%, P = 0.04). In the TCD group faster neutrophil (13 vs 22 days, P = 0.02) and platelet recoveries (18 vs 26 days, P < 0.001) were noted. The relapse risk was higher after TCD (57.5 vs 21.5%, P = 0.04). Overall survival probability at 10 years was identical in both groups (54 vs 53.5%, P = 0.33). We found a relationship between the number of T cells in the graft and the occurrence of major complications (P < 0.001) and relapse (P = 0.03). This comparative analysis shows that graft-derived T cells have a major role in overall BMT-related toxicity and that partial TCD is an acceptable approach in terms of survival for patients between 40 and 50 years of age. |
| doi_str_mv | 10.1038/sj.bmt.1703268 |
| format | Article |
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Only patients with chronic myeloid leukemia in first chronic phase or acute leukemia/myelodysplasia in first or second remission were included. Except for age (median 28 vs 42 years), both groups were comparable in terms of diagnosis, conditioning regimen and growth factor support. TCD significantly reduced >grade II acute GVHD (0 vs 24%, P = 0.02), chronic GVHD (8.5 vs 45%, P = 0.007) and other major bone marrow transplant (BMT)-related complications (4 vs 36%, P = 0.005). TCD decreased overall transplant-related mortality (11.5 vs 36%, P = 0.04). In the TCD group faster neutrophil (13 vs 22 days, P = 0.02) and platelet recoveries (18 vs 26 days, P < 0.001) were noted. The relapse risk was higher after TCD (57.5 vs 21.5%, P = 0.04). Overall survival probability at 10 years was identical in both groups (54 vs 53.5%, P = 0.33). We found a relationship between the number of T cells in the graft and the occurrence of major complications (P < 0.001) and relapse (P = 0.03). This comparative analysis shows that graft-derived T cells have a major role in overall BMT-related toxicity and that partial TCD is an acceptable approach in terms of survival for patients between 40 and 50 years of age.</description><identifier>ISSN: 0268-3369</identifier><identifier>EISSN: 1476-5365</identifier><identifier>DOI: 10.1038/sj.bmt.1703268</identifier><identifier>PMID: 11753544</identifier><identifier>CODEN: BMTRE9</identifier><language>eng</language><publisher>Basingstoke: Nature Publishing Group</publisher><subject>Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bone marrow ; Bone marrow transplantation ; Bone Marrow Transplantation - adverse effects ; Bone Marrow Transplantation - methods ; Bone Marrow Transplantation - mortality ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Care and treatment ; Chronic myeloid leukemia ; Cohort Studies ; Comparative analysis ; Complications ; Cyclosporins ; Depletion ; Dosage and administration ; Female ; Graft Survival ; Graft versus host disease ; Graft vs Host Disease - prevention & control ; Graft-versus-host reaction ; Grafting ; Growth factors ; Health aspects ; Histocompatibility antigen HLA ; Humans ; Kinetics ; Leukemia ; Leukemia - complications ; Leukemia - mortality ; Leukemia - therapy ; Leukocytes (neutrophilic) ; Lymphocyte Count ; Lymphocyte Depletion ; Lymphocytes ; Lymphocytes T ; Male ; Medical sciences ; Methotrexate ; Middle Aged ; Myelodysplastic syndrome ; Myeloid leukemia ; Prophylaxis ; Recurrence ; Remission ; Stem cell transplantation ; Survival ; Survival Analysis ; T cells ; T-Lymphocytes - cytology ; Toxicity ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation ; Transplantation, Homologous ; Transplantation, Isogeneic</subject><ispartof>Bone marrow transplantation (Basingstoke), 2001-11, Vol.28 (10), p.917-922</ispartof><rights>2002 INIST-CNRS</rights><rights>COPYRIGHT 2001 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Nov 2001</rights><rights>Macmillan Publishers Limited 2001.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c545t-1f7c305207b51f80e62d083828886cf3ba015f60d188adfcf8724b4d624e87ec3</citedby><cites>FETCH-LOGICAL-c545t-1f7c305207b51f80e62d083828886cf3ba015f60d188adfcf8724b4d624e87ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14142256$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11753544$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SCHOTS, R</creatorcontrib><creatorcontrib>VAN RIET, I</creatorcontrib><creatorcontrib>BEN OTHMAN, T</creatorcontrib><creatorcontrib>TRULLEMANS, F</creatorcontrib><creatorcontrib>DE WAELE, M</creatorcontrib><creatorcontrib>VAN CAMP, B</creatorcontrib><title>The impact of partial T cell depletion on overall transplant-related toxicity, graft function and survival after HLA-identical allogeneic bone marrow transplantation in standard risk adult patients with leukemia</title><title>Bone marrow transplantation (Basingstoke)</title><addtitle>Bone Marrow Transplant</addtitle><description>In this single-center study, a consecutive cohort of 59 adult patients transplanted with HLA-identical bone marrow and receiving graft-versus-host disease (GVHD) prophylaxis with either standard cyclosporine/methotrexate (n = 33) or partial T cell depletion (E-rosetting) (TCD, n = 26 were analyzed). Only patients with chronic myeloid leukemia in first chronic phase or acute leukemia/myelodysplasia in first or second remission were included. Except for age (median 28 vs 42 years), both groups were comparable in terms of diagnosis, conditioning regimen and growth factor support. TCD significantly reduced >grade II acute GVHD (0 vs 24%, P = 0.02), chronic GVHD (8.5 vs 45%, P = 0.007) and other major bone marrow transplant (BMT)-related complications (4 vs 36%, P = 0.005). TCD decreased overall transplant-related mortality (11.5 vs 36%, P = 0.04). In the TCD group faster neutrophil (13 vs 22 days, P = 0.02) and platelet recoveries (18 vs 26 days, P < 0.001) were noted. The relapse risk was higher after TCD (57.5 vs 21.5%, P = 0.04). Overall survival probability at 10 years was identical in both groups (54 vs 53.5%, P = 0.33). We found a relationship between the number of T cells in the graft and the occurrence of major complications (P < 0.001) and relapse (P = 0.03). This comparative analysis shows that graft-derived T cells have a major role in overall BMT-related toxicity and that partial TCD is an acceptable approach in terms of survival for patients between 40 and 50 years of age.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Bone Marrow Transplantation - adverse effects</subject><subject>Bone Marrow Transplantation - methods</subject><subject>Bone Marrow Transplantation - mortality</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Care and treatment</subject><subject>Chronic myeloid leukemia</subject><subject>Cohort Studies</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Cyclosporins</subject><subject>Depletion</subject><subject>Dosage and administration</subject><subject>Female</subject><subject>Graft Survival</subject><subject>Graft versus host disease</subject><subject>Graft vs Host Disease - prevention & control</subject><subject>Graft-versus-host reaction</subject><subject>Grafting</subject><subject>Growth factors</subject><subject>Health aspects</subject><subject>Histocompatibility antigen HLA</subject><subject>Humans</subject><subject>Kinetics</subject><subject>Leukemia</subject><subject>Leukemia - complications</subject><subject>Leukemia - mortality</subject><subject>Leukemia - therapy</subject><subject>Leukocytes (neutrophilic)</subject><subject>Lymphocyte Count</subject><subject>Lymphocyte Depletion</subject><subject>Lymphocytes</subject><subject>Lymphocytes T</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Methotrexate</subject><subject>Middle Aged</subject><subject>Myelodysplastic syndrome</subject><subject>Myeloid leukemia</subject><subject>Prophylaxis</subject><subject>Recurrence</subject><subject>Remission</subject><subject>Stem cell transplantation</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>T cells</subject><subject>T-Lymphocytes - cytology</subject><subject>Toxicity</subject><subject>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</subject><subject>Transplantation</subject><subject>Transplantation, Homologous</subject><subject>Transplantation, Isogeneic</subject><issn>0268-3369</issn><issn>1476-5365</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1ks1u1DAUhSMEoqWwZYksKroigx07jmc5qoAijcRmWEeOf2Y8dZxgO1P6nLwQN2VECyqKpUjX3z2-Pj5F8ZrgBcFUfEj7RdfnBWkwrbh4UpwS1vCyprx-WpxiKJWU8uVJ8SKlPcaEMVw_L04IaWpaM3Za_NzsDHL9KFVGg0WjjNlJjzZIGe-RNqM32Q0BzetgooRijjKk0cuQy2i8zEajPPxwyuXb92gbpc3ITkHdtcmgUZriwR1AFHZMRFfrVem0Cdmpueb9sDXBOIW6IRjUyxiHmwdnyDsdF1DKICajRtGlayT15DOMmx0oJXTj8g55M12b3smXxTMrfTKvjv-z4tunj5vLq3L99fOXy9W6VDWrc0lsoyiuK9x0NbECG15pLKiohBBcWdpJTGrLsSZCSG2VFU3FOqZ5xYxojKJnxcVv3TEO3yeTctu7NPsmgxmm1BIBHhPKATz_B9wPUwwwW1txVlWM4ooC9fa_FOGcNUsA_0htpTetC3YAq9R8brsiyyWMSMkSqMUjFHwa_FHgs3VQ_6vh4kHDzkifd2nw02x-elRZxSGlaGw7RgePdtsS3M6JbNO-hUS2x0RCw5vjraauN_oeP0YQgHdHQCZIhIWXVy7dc4yAQzWnvwDyBOuv</recordid><startdate>20011101</startdate><enddate>20011101</enddate><creator>SCHOTS, R</creator><creator>VAN RIET, I</creator><creator>BEN OTHMAN, T</creator><creator>TRULLEMANS, F</creator><creator>DE WAELE, M</creator><creator>VAN CAMP, B</creator><general>Nature Publishing Group</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7QP</scope><scope>7T5</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope></search><sort><creationdate>20011101</creationdate><title>The impact of partial T cell depletion on overall transplant-related toxicity, graft function and survival after HLA-identical allogeneic bone marrow transplantation in standard risk adult patients with leukemia</title><author>SCHOTS, R ; VAN RIET, I ; BEN OTHMAN, T ; TRULLEMANS, F ; DE WAELE, M ; VAN CAMP, B</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c545t-1f7c305207b51f80e62d083828886cf3ba015f60d188adfcf8724b4d624e87ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Bone Marrow Transplantation - adverse effects</topic><topic>Bone Marrow Transplantation - methods</topic><topic>Bone Marrow Transplantation - mortality</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Care and treatment</topic><topic>Chronic myeloid leukemia</topic><topic>Cohort Studies</topic><topic>Comparative analysis</topic><topic>Complications</topic><topic>Cyclosporins</topic><topic>Depletion</topic><topic>Dosage and administration</topic><topic>Female</topic><topic>Graft Survival</topic><topic>Graft versus host disease</topic><topic>Graft vs Host Disease - prevention & control</topic><topic>Graft-versus-host reaction</topic><topic>Grafting</topic><topic>Growth factors</topic><topic>Health aspects</topic><topic>Histocompatibility antigen HLA</topic><topic>Humans</topic><topic>Kinetics</topic><topic>Leukemia</topic><topic>Leukemia - complications</topic><topic>Leukemia - mortality</topic><topic>Leukemia - therapy</topic><topic>Leukocytes (neutrophilic)</topic><topic>Lymphocyte Count</topic><topic>Lymphocyte Depletion</topic><topic>Lymphocytes</topic><topic>Lymphocytes T</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Methotrexate</topic><topic>Middle Aged</topic><topic>Myelodysplastic syndrome</topic><topic>Myeloid leukemia</topic><topic>Prophylaxis</topic><topic>Recurrence</topic><topic>Remission</topic><topic>Stem cell transplantation</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>T cells</topic><topic>T-Lymphocytes - cytology</topic><topic>Toxicity</topic><topic>Transfusions. Complications. Transfusion reactions. Cell and gene therapy</topic><topic>Transplantation</topic><topic>Transplantation, Homologous</topic><topic>Transplantation, Isogeneic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SCHOTS, R</creatorcontrib><creatorcontrib>VAN RIET, I</creatorcontrib><creatorcontrib>BEN OTHMAN, T</creatorcontrib><creatorcontrib>TRULLEMANS, F</creatorcontrib><creatorcontrib>DE WAELE, M</creatorcontrib><creatorcontrib>VAN CAMP, B</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Bone marrow transplantation (Basingstoke)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SCHOTS, R</au><au>VAN RIET, I</au><au>BEN OTHMAN, T</au><au>TRULLEMANS, F</au><au>DE WAELE, M</au><au>VAN CAMP, B</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of partial T cell depletion on overall transplant-related toxicity, graft function and survival after HLA-identical allogeneic bone marrow transplantation in standard risk adult patients with leukemia</atitle><jtitle>Bone marrow transplantation (Basingstoke)</jtitle><addtitle>Bone Marrow Transplant</addtitle><date>2001-11-01</date><risdate>2001</risdate><volume>28</volume><issue>10</issue><spage>917</spage><epage>922</epage><pages>917-922</pages><issn>0268-3369</issn><eissn>1476-5365</eissn><coden>BMTRE9</coden><abstract>In this single-center study, a consecutive cohort of 59 adult patients transplanted with HLA-identical bone marrow and receiving graft-versus-host disease (GVHD) prophylaxis with either standard cyclosporine/methotrexate (n = 33) or partial T cell depletion (E-rosetting) (TCD, n = 26 were analyzed). Only patients with chronic myeloid leukemia in first chronic phase or acute leukemia/myelodysplasia in first or second remission were included. Except for age (median 28 vs 42 years), both groups were comparable in terms of diagnosis, conditioning regimen and growth factor support. TCD significantly reduced >grade II acute GVHD (0 vs 24%, P = 0.02), chronic GVHD (8.5 vs 45%, P = 0.007) and other major bone marrow transplant (BMT)-related complications (4 vs 36%, P = 0.005). TCD decreased overall transplant-related mortality (11.5 vs 36%, P = 0.04). In the TCD group faster neutrophil (13 vs 22 days, P = 0.02) and platelet recoveries (18 vs 26 days, P < 0.001) were noted. The relapse risk was higher after TCD (57.5 vs 21.5%, P = 0.04). Overall survival probability at 10 years was identical in both groups (54 vs 53.5%, P = 0.33). We found a relationship between the number of T cells in the graft and the occurrence of major complications (P < 0.001) and relapse (P = 0.03). This comparative analysis shows that graft-derived T cells have a major role in overall BMT-related toxicity and that partial TCD is an acceptable approach in terms of survival for patients between 40 and 50 years of age.</abstract><cop>Basingstoke</cop><pub>Nature Publishing Group</pub><pmid>11753544</pmid><doi>10.1038/sj.bmt.1703268</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0268-3369 |
| ispartof | Bone marrow transplantation (Basingstoke), 2001-11, Vol.28 (10), p.917-922 |
| issn | 0268-3369 1476-5365 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_18354136 |
| source | MEDLINE; Nature; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bone marrow Bone marrow transplantation Bone Marrow Transplantation - adverse effects Bone Marrow Transplantation - methods Bone Marrow Transplantation - mortality Bone marrow, stem cells transplantation. Graft versus host reaction Care and treatment Chronic myeloid leukemia Cohort Studies Comparative analysis Complications Cyclosporins Depletion Dosage and administration Female Graft Survival Graft versus host disease Graft vs Host Disease - prevention & control Graft-versus-host reaction Grafting Growth factors Health aspects Histocompatibility antigen HLA Humans Kinetics Leukemia Leukemia - complications Leukemia - mortality Leukemia - therapy Leukocytes (neutrophilic) Lymphocyte Count Lymphocyte Depletion Lymphocytes Lymphocytes T Male Medical sciences Methotrexate Middle Aged Myelodysplastic syndrome Myeloid leukemia Prophylaxis Recurrence Remission Stem cell transplantation Survival Survival Analysis T cells T-Lymphocytes - cytology Toxicity Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation Transplantation, Homologous Transplantation, Isogeneic |
| title | The impact of partial T cell depletion on overall transplant-related toxicity, graft function and survival after HLA-identical allogeneic bone marrow transplantation in standard risk adult patients with leukemia |
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