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Graft failure in patients receiving T cell-depleted HLA-identical allogeneic marrow transplants.

Publication ,  Journal Article
Martin, PJ; Hansen, JA; Torok-Storb, B; Durnam, D; Przepiorka, D; O'Quigley, J; Sanders, J; Sullivan, KM; Witherspoon, RP; Deeg, HJ
Published in: Bone Marrow Transplant
September 1988

Results of a previous study suggested that the risk of graft failure after transplantation of HLA-identical T cell-depleted marrow may be influenced by the preparative regimen. Subsequent clinical trials were carried out to clarify this relationship and to determine whether post-transplant immunosuppression could have an effect on graft durability. Two factors were found to be associated with graft failure. Patients with hematologic malignancy given a preparative regimen of cyclophosphamide (120 mg/kg) and 15.75 Gy fractionated total body irradiation (TBI) had a 27% cumulative incidence of graft failure, which was less than the 69% incidence seen previously in patients given cyclophosphamide and 12.0 Gy fractionated TBI (p less than 0.05, log-rank test). Patients with acute leukemia had a higher risk of graft failure than patients with chronic myelogenous leukemia (p less than 0.005). The incidence of graft failure was not influenced by post-transplant immunosuppression with cyclosporine, methotrexate or a combination of cyclosporine plus methotrexate or by the omission of all post-transplant immunosuppression. Similarly, graft failure was not associated with the complement lot used for marrow treatment, the recovery of BFU-E or CFU-GM, or with the number of nucleated cells or T cells in the graft. The effect of primary diagnosis and the inverse relationship between the amount of pretransplant TBI and the graft failure rate suggest that a host factor may have been involved in a presumably immune-mediated rejection. This observation further leads to the inference that certain T cells present in donor marrow can suppress host immunity or help to maintain function of the graft.

Duke Scholars

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

September 1988

Volume

3

Issue

5

Start / End Page

445 / 456

Location

England

Related Subject Headings

  • T-Lymphocytes
  • Lymphocyte Depletion
  • Immunosuppressive Agents
  • Immunology
  • Humans
  • HLA Antigens
  • Graft vs Host Disease
  • Graft Rejection
  • Clinical Trials as Topic
  • Bone Marrow Transplantation
 

Citation

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MLA
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Martin, P. J., Hansen, J. A., Torok-Storb, B., Durnam, D., Przepiorka, D., O’Quigley, J., … Deeg, H. J. (1988). Graft failure in patients receiving T cell-depleted HLA-identical allogeneic marrow transplants. Bone Marrow Transplant, 3(5), 445–456.
Martin, P. J., J. A. Hansen, B. Torok-Storb, D. Durnam, D. Przepiorka, J. O’Quigley, J. Sanders, K. M. Sullivan, R. P. Witherspoon, and H. J. Deeg. “Graft failure in patients receiving T cell-depleted HLA-identical allogeneic marrow transplants.Bone Marrow Transplant 3, no. 5 (September 1988): 445–56.
Martin PJ, Hansen JA, Torok-Storb B, Durnam D, Przepiorka D, O’Quigley J, et al. Graft failure in patients receiving T cell-depleted HLA-identical allogeneic marrow transplants. Bone Marrow Transplant. 1988 Sep;3(5):445–56.
Martin, P. J., et al. “Graft failure in patients receiving T cell-depleted HLA-identical allogeneic marrow transplants.Bone Marrow Transplant, vol. 3, no. 5, Sept. 1988, pp. 445–56.
Martin PJ, Hansen JA, Torok-Storb B, Durnam D, Przepiorka D, O’Quigley J, Sanders J, Sullivan KM, Witherspoon RP, Deeg HJ. Graft failure in patients receiving T cell-depleted HLA-identical allogeneic marrow transplants. Bone Marrow Transplant. 1988 Sep;3(5):445–456.

Published In

Bone Marrow Transplant

ISSN

0268-3369

Publication Date

September 1988

Volume

3

Issue

5

Start / End Page

445 / 456

Location

England

Related Subject Headings

  • T-Lymphocytes
  • Lymphocyte Depletion
  • Immunosuppressive Agents
  • Immunology
  • Humans
  • HLA Antigens
  • Graft vs Host Disease
  • Graft Rejection
  • Clinical Trials as Topic
  • Bone Marrow Transplantation