A randomized double blind trial of t-cell depletion with cds/8 cellector(r) in addition to cyclosporin, methotrexate and steroids fcn acute graft versus host disease prevention in hla mismatched bone marrow transplant

Acute graft versus host disease(AGVHD) is a major cuuse cf mortality in mismatched(MM) bone marrow transplant(BMT). T-eoil depletion(TCD) reduces AGVHD but increases relapse & rejection. 61 patients treated with MM BMT using total body irradiat'cn, cyclophosphamide, thiotepa, antithymocyte globulin with cyclospc., methotrexate and steroids for AGVHD prophylaxis were random. I for partial TCD. Stratification is reviewed below. TRANSPLANT TYPE TCD CONTROL Mismatched Related 1 6 Matched Unrelated Donor 26 22 Mismatched Unrelated Donor 4 2 DISEASE STAGE Good Risk Disease 17 18 Poor Risk Disease 14 12. AGE mean (range) 29 (1-51) 30 (2-51) Good risk disease was CML in first chronic phc.se cr acute leukemia in 1 to 2 complete relapse. Results are reviev,0J below. TCD CONTROL P-Valv? 100 day Actuarial 0.24(0.05,0.44) 0.67(0.49,0.8s1 O.CCCC Gradelll/IV AGVHD 9 month Actuarial 0.26(0.10,0.42) 0.17(0.03,0.30) 0.43 Overall Survival Cox regression for severe AGVHD revealed partial TCD improved outcome (p=0.002). 9 month overall survival was affected by patient age (p=0.018). In conclusion, partial TCD reduced the risk of severe AGVHD; the effect on survival requires longer follow-up.