Selective depletion of CD8+ cells for prevention of graft-versus-host disease after bone marrow transplantation: A randomized controlled trial

Stephen D Nimer, J. Giorgi, J. L. Gajewski, N. Ku, G. J. Schiller, K. Lee, M. Territo, W. Ho, S. Feig, M. Selch, V. Isacescu, T. A. Reichert, R. E. Champlin

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Abstract

We performed a prospective randomized, double-blind study to assess the efficacy of selective depletion of CD8+ bone marrow cells in preventing acute graft-versus-host disease (GVHD) in 38 patients undergoing HLA- identical sibling donor bone marrow transplantation for leukemia. All patients received CsA for GVHD prophylaxis. Nineteen patients received marrow depleted of CD8+ cells by ex vivo treatment with anti-leu2, an anti-CD8 mAb and complement; four patients had moderate (grade 1 or 2 acute GVHD) and the only patient who experienced grade 3 manifestations was a technical failure. The control group consisted of 19 patients who received unmodified bone marrow; one patient had grade 1, 4 patients had grade 2, and 10 had grade 3 or 4 acute GVHD. The actuarial incidence of grade ≥ 2 acute GVHD was 20±20% in the CD8-depleted group compared with 80±18% in the controls (P=0.004). Death in 5 of the control patients and the single patient in whom CD8 depletion was a technical failure was related to acute GVHD. Graft failure occurred in 2 patients in the CD8-depleted group and in none of the controls. Leukemic relapse occurred in 2 patients receiving CD8-depleted bone marrow and 2 patients in the control group. Seven patients receiving marrow depleted of CD8+ cells are alive and free of leukemia and 9 patients in the control group are alive, 7 of whom remain leukemia-free (P=0.88). The 3-year actuarial leukemia-free survival is 37±22% of the CD8-depleted group and 36±22% for the control group. These results indicate that selective depletion of CD8+ cells from the bone marrow significantly reduces the incidence and severity of acute GVHD.

Original languageEnglish
Pages (from-to)82-87
Number of pages6
JournalTransplantation
Volume57
Issue number1
StatePublished - Jan 31 1994
Externally publishedYes

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Graft vs Host Disease
Bone Marrow Transplantation
Randomized Controlled Trials
Leukemia
Bone Marrow
Control Groups
Bone Marrow Cells
Incidence
Double-Blind Method
Siblings

ASJC Scopus subject areas

  • Transplantation
  • Immunology

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Selective depletion of CD8+ cells for prevention of graft-versus-host disease after bone marrow transplantation : A randomized controlled trial. / Nimer, Stephen D; Giorgi, J.; Gajewski, J. L.; Ku, N.; Schiller, G. J.; Lee, K.; Territo, M.; Ho, W.; Feig, S.; Selch, M.; Isacescu, V.; Reichert, T. A.; Champlin, R. E.

In: Transplantation, Vol. 57, No. 1, 31.01.1994, p. 82-87.

Research output: Contribution to journalArticle

Nimer, SD, Giorgi, J, Gajewski, JL, Ku, N, Schiller, GJ, Lee, K, Territo, M, Ho, W, Feig, S, Selch, M, Isacescu, V, Reichert, TA & Champlin, RE 1994, 'Selective depletion of CD8+ cells for prevention of graft-versus-host disease after bone marrow transplantation: A randomized controlled trial', Transplantation, vol. 57, no. 1, pp. 82-87.
Nimer, Stephen D ; Giorgi, J. ; Gajewski, J. L. ; Ku, N. ; Schiller, G. J. ; Lee, K. ; Territo, M. ; Ho, W. ; Feig, S. ; Selch, M. ; Isacescu, V. ; Reichert, T. A. ; Champlin, R. E. / Selective depletion of CD8+ cells for prevention of graft-versus-host disease after bone marrow transplantation : A randomized controlled trial. In: Transplantation. 1994 ; Vol. 57, No. 1. pp. 82-87.
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