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Clonable T lymphocytes in T cell-depleted bone marrow transplants correlate
with development of graft-v-host disease
NA Kernan, NH Collins, L Juliano, T Cartagena, B Dupont and RJ O'Reilly
Early clinical trials using T lymphocyte-depleted human marrow for
transplantation have reported that such grafts reduce, to varying degrees,
both the incidence and the severity of graft-v-host disease (GVHD).
However, to date, no clear estimates have been made as to what degree of T
cell depletion is necessary to prevent GVHD in every case. To address this
problem, we used a limiting dilution assay (LDA) to quantitate residual
clonable T lymphocytes in human T cell-depleted bone marrow in 31
HLA-identical transplants for leukemia. The number of phytohemagglutinin
-interleukin 2-responsive T lymphocytes determined by LDA and expressed as
T cell per kilogram recipient weight was found to correlate with the
subsequent development of GVHD: no patients who received less than 1 X
10(5) T cell per kilogram developed GVHD (N = 24). Of the seven patients
who received 1 X 10(5) to 4.4 X 10(5) T cell per kilogram, four patients
developed grade I or II skin GVHD. This study thus provides a quantitative
estimate of the number of T lymphocytes necessary to initiate clinically
detectable GVHD in an HLA- identical host.
Volume 68,
Issue 3,
pp. 770-773,
09/01/1986
Copyright © 1986 by The American Society of Hematology
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