|
|
 Previous Article | Table of Contents | Next Article 
T-Cell-Depleted Allogeneic Bone Marrow Transplantation as
Postremission Therapy for Acute Myelogenous Leukemia: Freedom From
Relapse in the Absence of Graft-Versus-Host Disease
Esperanza B. Papadopoulos,
Matthew H. Carabasi,
Hugo Castro-Malaspina,
Barrett H. Childs,
Stephen Mackinnon,
Farid Boulad,
Alfred P. Gillio,
Nancy A. Kernan,
Trudy N. Small,
Paul Szabolcs,
Joanne Taylor,
Joachim Yahalom,
Nancy H. Collins,
Sharon
A. Bleau,
Patricia M. Black,
Glenn Heller,
Richard J. O' Reilly, and
James W. Young
From the Allogeneic Bone Marrow Transplantation Service, Division of
Hematologic Oncology, Department of Medicine; the Department of
Pediatrics; the Department of Nursing; the Department of Radiation
Oncology; the Department of Biostatistics and Epidemiology, Memorial
Sloan-Kettering Cancer Center, Cornell University Medical College, New
York; and The Laboratory of Cellular Physiology and Immunology, The
Rockefeller University, New York, NY.
Thirty-one consecutive patients with acute myelogenous leukemia
(AML) in first complete remission and 8 with AML in second complete
remission received T cell-depleted allogeneic bone marrow transplants
from HLA-identical sibling donors. Patients received myeloablative
cytoreduction consisting of hyperfractionated total body irradiation,
thiotepa, and cyclophosphamide. Those patients at risk for
immune-mediated graft rejection received additional immune suppression
with antithymocyte globulin and methylprednisolone in the early
peritransplant period. Patients with AML who underwent allogeneic
T-cell-depleted bone marrow transplantations (BMT) in first or second
remission have achieved respective disease-free survival (DFS)
probabilities of 77% (median follow-up at approximately 56 months) and
50% (median follow-up at approximately 48 months). Ten of 31 patients
transplanted in first remission were  40 years old and have attained
a DFS at 4 years of 70%. For patients with AML transplanted in first
or second remission, the respective cause-specific probabilities of
relapse were 3.2% or 12.5%, and those of nonleukemic mortality were
19.4% or 37.5%. There were no cases of immune-mediated graft
rejection and no cases of grade II to IV acute graft-versus-host
disease (GVHD). All survivors enjoy Karnofsky performance scores (KPS)
of 100%, except 2 patients with KPS of 80% to 90%.
T-cell-depleted allogeneic BMT can provide durable DFS together with
an excellent performance status in the majority of patients with de
novo AML. In addition, GVHD is not an obligatory correlate of the
graft-versus-leukemia benefit or freedom from relapse afforded by
allogeneic BMT administered as postremission therapy for AML. This
study provides a basis for prospective comparison with other
postremission therapies considered standard in the management of
patients with this disease.
Blood, Vol. 91 No. 3 (February 1), 1998:
pp. 1083-1090
© 1998 by The American Society of Hematology.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
A. A. Jakubowski, T. N. Small, J. W. Young, N. A. Kernan, H. Castro-Malaspina, K. C. Hsu, M.-A. Perales, N. Collins, C. Cisek, M. Chiu, et al.
T cell depleted stem-cell transplantation for adults with hematologic malignancies: sustained engraftment of HLA-matched related donor grafts without the use of antithymocyte globulin
Blood,
December 15, 2007;
110(13):
4552 - 4559.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. E. Heslop
To T-cell deplete or not
Blood,
November 1, 2005;
106(9):
2932 - 2932.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. van Besien, A. Artz, S. Smith, D. Cao, S. Rich, L. Godley, D. Jones, P. Del Cerro, D. Bennett, B. Casey, et al.
Fludarabine, Melphalan, and Alemtuzumab Conditioning in Adults With Standard-Risk Advanced Acute Myeloid Leukemia and Myelodysplastic Syndrome
J. Clin. Oncol.,
August 20, 2005;
23(24):
5728 - 5738.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Aversa, A. Terenzi, A. Tabilio, F. Falzetti, A. Carotti, S. Ballanti, R. Felicini, F. Falcinelli, A. Velardi, L. Ruggeri, et al.
Full Haplotype-Mismatched Hematopoietic Stem-Cell Transplantation: A Phase II Study in Patients With Acute Leukemia at High Risk of Relapse
J. Clin. Oncol.,
May 20, 2005;
23(15):
3447 - 3454.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. E. Foster, M. Marangolo, M. M. Sartor, S. I. Alexander, M. Hu, K. F. Bradstock, and D. J. Gottlieb
Human CD62L- memory T cells are less responsive to alloantigen stimulation than CD62L+ naive T cells: potential for adoptive immunotherapy and allodepletion
Blood,
October 15, 2004;
104(8):
2403 - 2409.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. S. Grewal, J. N. Barker, S. M. Davies, and J. E. Wagner
Unrelated donor hematopoietic cell transplantation: marrow or umbilical cord blood?
Blood,
June 1, 2003;
101(11):
4233 - 4244.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. R. Lewin, G. Heller, L. Zhang, E. Rodrigues, E. Skulsky, M. R. M. van den Brink, T. N. Small, N. A. Kernan, R. J. O'Reilly, D. D. Ho, et al.
Direct evidence for new T-cell generation by patients after either T-cell-depleted or unmodified allogeneic hematopoietic stem cell transplantations
Blood,
August 28, 2002;
100(6):
2235 - 2242.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y.-G. Yang, J. Qi, M.-G. Wang, and M. Sykes
Donor-derived interferon gamma separates graft-versus-leukemia effects and graft-versus-host disease induced by donor CD8 T cells
Blood,
May 13, 2002;
99(11):
4207 - 4215.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. J. Giles, A. Keating, A. H. Goldstone, I. Avivi, C. L. Willman, and H. M. Kantarjian
Acute Myeloid Leukemia
Hematology,
January 1, 2002;
2002(1):
73 - 110.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
V. T. Ho and R. J. Soiffer
The history and future of T-cell depletion as graft-versus-host disease prophylaxis for allogeneic hematopoietic stem cell transplantation
Blood,
December 1, 2001;
98(12):
3192 - 3204.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Bunjes, I. Buchmann, C. Duncker, U. Seitz, J. Kotzerke, M. Wiesneth, D. Dohr, M. Stefanic, A. Buck, S. V. Harsdorf, et al.
Rhenium 188-labeled anti-CD66 (a, b, c, e) monoclonal antibody to intensify the conditioning regimen prior to stem cell transplantation for patients with high-risk acute myeloid leukemia or myelodysplastic syndrome: results of a phase I-II study
Blood,
August 1, 2001;
98(3):
565 - 572.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Kornblau, I. Stiouf, V. Snell, D. Przepiorka, L. C. Stephens, R. Champlin, and F. C. Marini III
Preemptive Control of Graft-versus-Host Disease in a Murine Allogeneic Transplant Model Using Retrovirally Transduced Murine Suicidal Lymphocytes
Cancer Res.,
April 1, 2001;
61(8):
3355 - 3360.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
R. J. Soiffer, E. Weller, E. P. Alyea, P. Mauch, I. L. Webb, D. C. Fisher, A. S. Freedman, R. L. Schlossman, J. Gribben, S. Lee, et al.
CD6+ Donor Marrow T-Cell Depletion as the Sole Form of Graft-Versus-Host Disease Prophylaxis in Patients Undergoing Allogeneic Bone Marrow Transplant From Unrelated Donors
J. Clin. Oncol.,
February 15, 2001;
19(4):
1152 - 1159.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. F. Storb, R. Champlin, S. R. Riddell, M. Murata, S. Bryant, and E. H. Warren
Non-Myeloablative Transplants for Malignant Disease
Hematology,
January 1, 2001;
2001(1):
375 - 391.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. S. Tallman, P. A. Rowlings, G. Milone, M.-J. Zhang, W. S. Perez, D. Weisdorf, A. Keating, R. P. Gale, R. B. Geller, M. J. Laughlin, et al.
Effect of postremission chemotherapy before human leukocyte antigen-identical sibling transplantation for acute myelogenous leukemia in first complete remission
Blood,
August 15, 2000;
96(4):
1254 - 1258.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Zecca, A. Pession, C. Messina, F. Bonetti, C. Favre, A. Prete, S. Cesaro, F. Porta, I. Mazzarino, G. Giorgiani, et al.
Total Body Irradiation, Thiotepa, and Cyclophosphamide as a Conditioning Regimen for Children With Acute Lymphoblastic Leukemia in First or Second Remission Undergoing Bone Marrow Transplantation With HLA-Identical Siblings
J. Clin. Oncol.,
June 1, 1999;
17(6):
1838 - 1838.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Aversa, A. Terenzi, A. Carotti, R. Felicini, R. Jacucci, T. Zei, P. Latini, C. Aristei, A. Santucci, M. P. Martelli, et al.
Improved Outcome With T-Cell–Depleted Bone Marrow Transplantation for Acute Leukemia
J. Clin. Oncol.,
May 1, 1999;
17(5):
1545 - 1545.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
