Reference : Low T-cell chimerism is not followed by graft rejection after nonmyeloablative stem cell...
Scientific journals : Article
Human health sciences : Hematology
http://hdl.handle.net/2268/6288
Low T-cell chimerism is not followed by graft rejection after nonmyeloablative stem cell transplantation (NMSCT) with CD34-selected PBSC.
English
Baron, Frédéric mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Baudoux, Etienne mailto [Centre Hospitalier Universitaire de Liège - CHU > > Thérapie cellulaire >]
Frere, Pascale mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Tourqui, Soraya mailto [> >]
Schaaf-Lafontaine, Nicole mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie biologique et immuno hématologie >]
Herens, Christian mailto [Centre Hospitalier Universitaire de Liège - CHU > > Génétique >]
De Prijck, Bernard mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Fillet, Georges mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
Beguin, Yves mailto [Centre Hospitalier Universitaire de Liège - CHU > > Hématologie clinique >]
2003
Bone Marrow Transplantation
Nature Publishing Group
32
8
829-34
Yes (verified by ORBi)
International
0268-3369
London
United Kingdom
[en] Adult ; Aged ; Antigens, CD34/analysis ; Bone Marrow Transplantation/adverse effects ; Cell Separation ; Feasibility Studies ; Graft Rejection/diagnosis/immunology ; Graft vs Host Disease/diagnosis/immunology ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Male ; Middle Aged ; Pilot Projects ; T-Lymphocytes/chemistry/cytology ; Transplantation Chimera ; Transplantation Conditioning/methods
[en] We investigate the feasibility of CD34-selected peripheral blood stem cell (PBSC) transplantation followed by pre-emptive CD8-depleted donor lymphocyte infusions (DLI) after a minimal conditioning regimen. Six patients with advanced hematological malignancies ineligible for a conventional myeloablative transplant (n=5) or metastatic renal cell carcinoma (n=1), and with an HLA-identical (n=4) or alternative (n=2) donor were included. The nonmyeloablative conditioning regimen consisted in 2 Gy TBI alone (n=4), 2 Gy TBI and fludarabine (RCC patient, n=1) or cyclophosphamide and fludarabine (patient who had previously received 12 Gy TBI, n=1). Post transplant immunosuppression was carried out with cyclosporin (CyA) and mycophenolate mofetil (MMF). Initial engraftment was achieved in all patients. One out of six patients (17%) experienced grade > or =2 acute GVHD only after abrupt cyclosporin discontinuation and alpha interferon therapy for life-threatening tumor progression. T-cell chimerism was 23% (19-30) on day 28, 32% (10-35) on day 100, 78% (49-95) on day 180 and 99.5% (99-100) on day 365. Three out of four patients who had measurable disease before the transplant experienced a complete response. We conclude that CD34-selected NMSCT followed by CD8-depleted DLI is feasible and preserves engraftment and apparently also the graft-versus-leukemia (GVL) effect. Further studies are needed to confirm this encouraging preliminary report.
http://hdl.handle.net/2268/6288
10.1038/sj.bmt.1704220

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