IMPACT OF T-CELL DEPLETION ON OUTCOME OF ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR STANDARD-RISK LEUKAEMIAS
IMPACT OF T-CELL DEPLETION ON OUTCOME OF ALLOGENEIC BONE-MARROW TRANSPLANTATION FOR STANDARD-RISK LEUKAEMIAS
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DOI：
10.1016/s0140-6736(87)90763-x
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发表时间：
1987-07
期刊：
影响因子：
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通讯作者：
D. Maraninchi;D. Blaise;B. Rio;V. Leblond;F. Dreyfus;E. Gluckman;D. Guyotat;J. Pico;M. Michallet;N. Ifrah;A. Bordigoni
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文献类型：
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作者：
D. Maraninchi;D. Blaise;B. Rio;V. Leblond;F. Dreyfus;E. Gluckman;D. Guyotat;J. Pico;M. Michallet;N. Ifrah;A. Bordigoni
71 名接受 HLA 匹配骨髓移植 (BMT) 的白血病患者被随机分配接受全骨髓（A 组）或通过单克隆抗体（抗 CD4-CD5-CD8，B 组；抗 CD2-CD5-CD7，C 组）加补体治疗的去除 T 细胞的骨髓。所有患者在移植前接受环磷酰胺和全身照射，在BMT后接受环孢素治疗。骨髓治疗去除了 B 组 97% 的 T 细胞（中位数）和 C 组 99% 的 T 细胞。尽管 T 细胞耗竭患者的严重和轻度移植物抗宿主病 (GVHD) 均减少，但移植失败和复发增加。对照组的移植失败是由 GVHD 和移植并发症引起的，T 细胞耗尽组的移植失败是由排斥和复发引起的。各组之间的无复发生存期没有差异。如果不能更好地控制宿主免疫和骨髓中残留的白血病 T 细胞耗竭，则不应在标准风险患者中进行 BMT。
71 leukaemic patients having HLA-matched bone-marrow transplants (BMT) were randomised to receive whole marrow (group A) or marrow depleted of T cells by treatment with monoclonal antibodies (anti CD4-CD5-CD8, group B; anti CD2-CD5-CD7, group C) plus complement. All patients received cyclophosphamide and total body irradiation before transplantation and cyclosporin after BMT. Marrow treatment removed 97% of T cells (median) in group B and 99% in group C. Although both serious and mild graft-versus-host disease (GVHD) were reduced in T-cell depleted patients, graft failure and relapse were increased. Graft failure was caused by GVHD and transplant complications in the controls and by rejection and relapse in the T-cell depleted groups; relapse-free survival did not differ between the groups. Without better control of host immunity and of the residual leukaemia T-cell depletion of the marrow, BMT should not be pursued in standard-risk patients.